If you’re a new client, please complete the following forms, scan, and return them to me before our first session. Or you can mail them to me if you prefer.
Client Information Sheet-Payment Information
Release of Information
Your personal information (including name, birthdate, age, gender, address, phone number, email address, occupation, education level, emergency contact person, religious affiliation, reason(s) for seeking help) collected in the process of conducting therapy for the purpose of forming a diagnosis, developing a treatment plan and measuring progress will not be shared with third parties, partners, or joint ventures, or for marketing/promotional purposes.
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"Forgiving means giving up all hope for a better past." Lilly Tomlin
