Helpful Forms

If you are a new client, please complete the following forms and bring them to your first therapy session.

Adult Information Form.TPPC

Consent Form TPPC

Credit Card Authorization PDF

Fee Schedule and Financial Agreement TPPC

HIPPA_Authorization_2010-TPPC

Intake form PDF

 

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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