Forms for New Clients

For Adults and Couples

Please download and complete the following:

Informed Consent for Adults: Provides overview of treatment and payment. Please print; sign and bring to session. For couples, each person should complete his/her own.
Client Background: Provides brief overview of your concerns and background. Please download; complete in Word; print and bring to first session.
Symptom Inventory: A brief survey to understand your concerns. Please print; complete survey; and bring to first session. For couples, each person should complete his/her own.
Dyadic Adjustment Scale: A survey to assess ares of relational concern and strength. Please print; complete survey; and bring to first session. For couples, each person should complete his/her own.

You may review and download for your records:
HIPPA Policy

For Children and Adolescents

Informed Consent for Minors: Provides overview of treatment and payment. Please print; have BOTH PARENTS (unless one has sole legal custody or otherwise stated in custody orders) sign and bring to session.
Client Background: Provides brief overview of your concerns and background. Please download; complete in Word; print and bring to first session.
Symptom Inventory for Parents: A brief survey that allows parents to identify concerns for children 6-17. Please print; complete survey; and bring to first session.
Symptom Inventory for Adolescents: In addition to the parent inventory, children 11-17 should also complete their own symptom inventory. Please print; complete survey; and bring to first session.

You may review and download for your records:
HIPPA Policy