Helpful Forms

If you're a new client, please complete the Intake form and bring it to your first therapy session.  If you are using TeleHealth services you can complete this form online by downloading the form with adobe , using the all files format with the fill & sign option.  Send completed forms 24 hrs in advance of your session to [email protected]  
Let us know if you need assistance downloading and completing this form.

Note: To download Adobe Acrobat Reader for free, click here .

*    Client Psychotherapy Intake Form and Limits of Confidentiality/Therapy Cancellation Policy

To complete New Client Intake form online click on link below.  Make sure to fully complete the form prior to clicking submit.

https://form.jotform.com/20157...

For In Person Sessions please complete the form below for COVID-19 Informed consent and email prior to your session.

*   COVID-19 Informed Consent

Only complete the form below If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.) and to authorize release of psychotherapy information:

*     Authorization to Disclose Information Form

Location

In the Brookshire Office Complex , North of the Ferman Chevrolet Dealership. Turn on Carrollwood Place Circle, then right into complex then left.

Availability

Monday:

3:00 pm-7:00 pm

Tuesday:

10:00 am-7:00 pm

Wednesday:

3:00 pm-7:00 pm

Thursday:

10:00 am-7:00 pm

Friday:

Closed

Saturday:

By Appointment

Sunday:

Closed