Documents

This page provides links to various documents you may eventually need.  A great way to prepare for our introductory consultation is to read the Disclosure and Consent.  If we decide to work together the Full Packet provides all the documents you will need.  Please print and complete it before our next session so we can spend our time in conversation:

Adults

  1. Disclosure and Consent to Treatment: This document explains the agreement you are entering into with me as your therapist.  This document must be signed for treatment to commence.  I welcome your questions for clarification.
  2. Intake Form: This questionnaire provides me with information that allows me to know what it is that has brought you to therapy and the factors that have influenced your situation.
  3. Full Packet:  This document includes all of the above documents as well as those listed below for all clients.

Children/Adolescents

  1. Disclosure and Consent to Treatment: This document explains the agreement you as a parent/guardian are entering into with me as your child’s therapist. This document must be signed for treatment to commence. I welcome your questions for clarification.
  2. Intake Form: This questionnaire provides me with information that allows me to know what it is that has brought your child to therapy and the factors that have influenced their situation.
  3. Full Packet: This document includes all of the above documents as well as those listed below for all clients.

All Clients

  1. Privacy Notice: It is my duty to protect your privacy. This document explains how I will work to perform that responsibility.
  2. Communication Policy: This document provides you with information on how to reach me and the limitations of confidentiality provided by typical means of communication.
  3. Credit Card Authorization: If you choose, you can use this form to authorize payment for services via your credit card.
  4. Release of Information: This document is only necessary if there is someone in your life you believe it would be helpful for me to discuss your situation with in order to provided effective treatment.