New Clients
If you are considering therapy, you may have questions about what that involves. If you’ve seen a therapist before, you may want to have a clearer sense of my style and approach to this work. Either way, feel free to call me for a free phone consultation; we can discuss what brings you to therapy and address any questions you may have about my background and style.
If you have questions about fees or insurance, you can see my web page dealing specifically with those issues.
If you’re ready to begin, and we’ve already spoken and made an appointment, you can speed the process by downloading and completing my intake forms. Links to them are listed below.
Each individual client will need to complete the following forms:
If you need to engage in teletherapy for health or other reasons, you’ll need to complete this consent form also:
For couples, each individual must complete the above form as well as this one:
If you will be using insurance to cover part of your fees, you can obtain a copy of my privacy practices from the first link below. I’ll also need for you to complete the Receipt of Notice of Privacy Practices form, to acknowledge that you have received these, and the Health Insurance Claim Form.
- Notice of Privacy Practices
- Receipt of Notice of Privacy Practices
- Consent to Disclose PHI
- Insurance Details Form
If you don’t have health insurance, you can obtain a copy of my Notice of Good Faith Estimate from the first link below. You’ll also need to complete the Receipt of Notice of Good Faith Estimate form, to acknowledge you have received this.
For any clients who are children, one parent or guardian will need to complete the intake form listed below. Adolescents and children will need to complete the following form, to the best of their ability:
If you’re seeing another professional with whom I may need to speak, then you will need to complete the release form below, enabling me to talk with them. On the form you can specify exactly what you do and do not want me to discuss with them. If you’re taking any psychotropic medication, for example, I’ll need a release to talk to the prescribing MD.
This may seem like a lot of work, but it will help speed us through the initial process of getting to know one another and determining the best way to meet your needs. Thank you for taking the time to complete these. I look forward to our working together.