If you have made an appointment to see me, please download and complete the following documents:
Adults
- Print 2 copies of Disclosure Statement: Read and keep one for your personal records; initial and sign the other copy and bring to your first appointment.
- Print out a copy of the HIPAA Statement: Read and keep for your own records.
- Print out Adult Questionnaire Form: Fill out and bring to first appointment.
Couples/Families
- Print 2 copies of Disclosure Statement: Read and keep one for your personal records; initial and sign the other copy and bring to your first appointment.
- Print out a copy of the HIPAA Statement: Read and keep for your own records.
- Print out Families and Couples Guidelines. Fill it out and bring it to the first appointment.
- Print out Family & Couple Questionnaire Form: Fill out and bring to first appointment.
Children/Youth
- Print 2 copies of Disclosure Statement: Read and keep one for your personal records; initial and sign the other copy and bring to your first appointment.
- Print out a copy of the HIPAA Statement: Read and keep for your own records.
- Print out Child/Youth Questionnaire Form: Parents fill out and bring to first appointment.
- Print out Youth Mood & Behavior Rating Scale: Parents fill out and bring to first appointment.