Helpful Forms

• Consent and Cancellation Policy
• HIPPA Notice
• Intake Questionnaire
• SNAP Questionnaire
• VIDEO Sessions
• Credit Card Authorization Form
• List of Symptoms
• Mandatory Reporting Requirements
• BASIS-32 Form

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

• Authorization to Disclose Information Form

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