Helpful Forms

If you're a first-time client, please review and complete the following forms and email them to me prior to your first session at




If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), please ensure you complete the Consent to Release form.

Intake Form

Confidentiality and Cancellation Policy

Consent to Release

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



Member of the

Advisory Board of

American Distance

Counseling Association
 is a division of About Feelings Network
Private Counseling, Education, and Referrals Over the Internet Since 1997

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