Existing Clients

Release of Information

In the event that you would like me to coordinate care with another provider (for example your primary care physician, psychiatrist, etc.) or communicate with someone other than yourself regarding your treatment, you will need to complete the Release of Information form. This form will authorize me to release psychotherapy information to the party designated by you. Please bring this form completed to your next therapy session so we can discuss what information you intend to be released.

Late Cancellation Payment

If you were unable to cancel your appointment within 24 hours prior to your session please use this form to make a payment. Once the payment is received I will contact you to schedule a future appointment. If you have questions please feel free to contact me.

Making a Payment

If you need to make a payment prior to your next therapy session please use this form. Please note, I do accept cash, checks, and credit/debit cards at the time of your therapy session.