Patient Resources & Forms

  • Treatment Plan

    2-Page PDF

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  • Statement of Understanding & Consent

    4-Page PDF

    This document describes my therapy practice as it will pertain to us should we agree to work together. I welcome your questions, feedback, and reactions to the content.

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  • Multiaxial Evaluation Report

    2-Page PDF

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  • Authorization to Release Information

    1-Page PDF

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  • HIPPA Form

    1-Page PDF

    Privacies of Information Policies: This form describes the confidentiality of your medical records, how the information is used, your rights, and how you may obtain this information.

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  • Patient-Psychotherapist Service Agreement

    7-Page PDF

    This document contains important information about my professional services and business policies.

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  • The Rights of Clients

    1-Page PDF

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  • Client Personal Information Form

    5-Page PDF

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  • Limits of the Therapy Relationship

    1-Page PDF

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