Helpful Forms

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

  • Client Psychotherapy Intake Form
  • Hipaa Consent Form
  • Consent for Services
  • Limits of Confidentiality/Therapy Cancellation Policy
  • Authorization to Disclose Information Form
Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form
Consent for Services
HIPAA Release Form

Note: To download Adobe Acrobat Reader for free, click here .

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Areas I Serve:

Michigan & Florida

Virtual Office Hours

Monday - Friday

10:00AM - 6:00PM