Child Client Forms
I f you're a new client, please complete the following forms and bring them to your first therapy session.
- New Patient Intake Form
- Initial Consent of Evaluation
- Informed Consent, Fees & Cancellation
- Consent for Treatment of a Minor
- Initial Parent Questionnaire
- Emergency Contact Sheet
- Notice of Privacy Practices (Patient's Copy)
- NPP Acknowledgment
- Text Messaging Policy
- EMDR Consent Form
- LITE Parent Form
- Parent CROPS Form
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:
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