Client Forms

Client Forms

If you are a new client, please download and print the Consent for Treatment, Client Info Form, Electronic Media Policy, and Email Consent Form. Fill them out, sign them, and bring them to our first meeting. The map, e-payment disclosure, and email & text risk questionnaire are for your information and you may keep them.

Consent for Treatment

Client Information Form

E-pay Disclosure

Electronic Media Policy

Email & Text Questionnaire

E-mail Consent Form

Office map


Send a Message

8/1/17 – do not use this form for now. It is not working. Email me from the link above.