Client Data Summary:

The Client Summary Data Sheet is an extremely useful tool for both you and I to use at the beginning of therapy.   By taking approximately 20 minutes to fill it out and then submitting it to me, we can begin the therapy process already informed of your demographic background information, what your current problem(s) are that bring you to therapy, your family background and current status, your history (if any) as a therapy client, which medications you are using for medical and psychological remedies, any alcohol or substance use and history, how you feel about therapy, and what kind of approach you feel works best while in therapy. 

After completing the form, you may notice that by writing all the information down, you are more clear about what is bothering you, and how you want to approach therapy.  This can foster a great start to the therapy process!

Ideally, the form should be submitted to me on or before the first session.

Click here to get a printable copy of the Client Summary Data Sheet

Informed Consent for Clients:

The Informed Consent Form includes important information about fees and payment, my cancellation policy, what to do if you are in crisis, and the limits of confidentiality.  Please read this over, sign it, and submit it to me during the first therapy session.

Click here to get a printable copy of the Informed Consent for Clients form

Authorization for Use or Disclosure of Protected Health Information:

This form is useful if you have a need to release any Protected Health Information (PHI) to a third party, or if you have a need for a third party to release PHI to me. 

Click here to get a printable copy of the Authorization for Use or Disclosure of PHI form.