Welcome!

You're One Step Closer to Your Transformation

Please ensure the following forms are completed and submitted prior to our first meeting. These forms help me understand your needs and ensure our session is tailored to you.

Submitting these forms ahead of time allows us to focus fully on you during our first session.

First Name

Last Name

Phone *

Email *

General Information Acknowledgement

I completed the General Information Acknowledgment *

Yes

Notice of Privacy Practices & Acknowledgement

I completed the Notice of Privacy Practices & Acknowledgement *

Yes

Informed Consent for Psychotherapy

I completed the Informed Consent for Psychotherapy *

Yes

Telehealth Treatment Consent

I completed the Telehealth Treatment Consent *

Yes

Biopsychosocial Assessment

I completed the Biopsychosocial Assessment *

Yes

Standard Intake Questionnaire

I completed the Standard Intake Questionnaire *

Yes

Disclosure Statement

I completed the Disclosure Statement *

Yes