Intake Form


By downloading, printing and completing this form prior to our first visit, you will save more time for talking rather than paperwork. If you are unable to complete this in advance for any reason, please arrive 5-10 before your scheduled appointment time to fill this out in the waiting room. Thank you.

Informed Consent

“Informed Consent” refers to a body of policy disclosures that all licensed mental health professionals are required to provide to the clients they treat.  It covers many of the subject areas found elsewhere on my website, and much more. Please take the time to look this document over and feel free to ask for any further explanation in order to ensure that you clear and confident about your treatment experience.

Informed consent is for both your protection and the provider's. Clients need to understand their rights, risks, and responsibilities when entering a therapeutic process, and the Informed Consent disclosure is what makes all of these elements transparent.