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Blue Mountains
Blue Mountains

Helpful Forms



For new clients prior to your first session:

Please complete a Client Psychotherapy Intake Form and the Limits of Confidentiality/Therapy Cancellation Policy form, and bring them to your first therapy session (this is required for all clients).  In addition, couples should each fill out the R-DAS Form for Couples Therapy.



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:


Note: In order to access the above forms you will need Adobe Acrobat Reader.  To download Adobe Acrobat Reader for free,
click here.

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Helpful Forms

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