Helpful Forms

If you've decided to be a new client, Welcome! I sincerely look forward to helping.


For your perusal and records, including specifics about my practice policies:

• Agreement for Psychological Services
• Arizona Notice Form HIPAA
• Professional Will
  

Please complete and sign the following applicable forms and bring them to your first therapy session:

• Client Information Sheet
• Child Client Intake Form or Adult Client Intake Form
• Informed Consent Agreement signature page
• Request for Confidential Handling of Health Information
• Collections Policy

If you would like me to coordinate care with another provider (for example, your child's psychiatrist, primary care physician, school counselor, etc.), please complete this form to authorize release of protected health information:

• Authorization for Release/Request of Information

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