New Client Forms

Download, print, and complete the forms and bring them with you to your first appointment. If I am an “in-network provider,” also bring your insurance card.

Your download includes the following forms:

  • Client Disclosure Statement, Information and Consent Form
  • Client Information Form
  • Addendums Concerning Confidentiality
  • Consent to Use and Disclose Information for Treatment, Payment, and Health Care Operations (TPO)
    This form is related to the NOTICE OF PRIVACY PRACTICE and is required for us to work together

Notice of Privacy Practice

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