New Client Forms

Please download and fill out forms prior to first visit. Call our office with any questions you might have.

New Client Information

I charge $120 per hour. Please contact me if you need a sliding rate.

Insurance

I am not in network for insurance. If you are interested in getting insurance reimbursement for my services, please contact your health insurance and ask if they will accept a superbill from an out of network practitioner. For out of network reimbursement, I am happy to compose superbills for clients who request it.

Directions

Come to 220 River St E. My office building is across the street from the Limelight Hotel, at the corner of River St. E and Washington. There is a black sign with the building number out front. Come towards the gray building and come in the first door on your left. My office is upstairs.

Forms

The forms below should be downloaded and filled-out prior to your first visit. If you have any questions or concerns about the forms, please call my office.

Forms

Consent for Treatment, Children & Families

Download Form

Consent for Treatment, Individuals & Couples

Download Form

Client Intake, Adult

Download Form

Client Intake, Child

Download Form

Release of Information

Download Form