Initial Intake Forms to Print
Upon scheduling of an initial session, all intake documents will be sent to you to be completed electronically. You can then submit them electronically back to me through my electronic health record. If you are unable to complete the forms online or they do not arrive on time please print, complete, and bring these forms to your initial intake to expedite the process of checking in. Thank you!
Informed Consent for Telehealth Treatment
This consent form reviews the pros and cons of receiving telehealth services. This also reviews expectations regarding the receipt of telehealth services including a safe and secure environment, appropriate attire, being physically located in the State of Connecticut or State of Florida.
Release of Information
Please complete a release of information for your primary care physician, previous mental health provider, significant other who may be attending treatment with you (couples or family sessions), or your child's school (for clients attending school). If you do not want me to coordinate please fill out the form and do not check off permissions.