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New Client Forms

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Intake Packet

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

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Authorization Form

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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Credit Card Authorization Form

If you would like to use a credit card as a form of payment, I will leave your credit card on file. Please complete the form below.

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Telehealth Consent Form

If you receive any Telehealth Services, please complete the following form.

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Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

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