Forms
Unlocking Potential, One Mind at a Time
Release of Information
This form gives permission to consult with other treating providers to communicate (back & forth) relevant clinical information.
Individual Intake Form
This form provides some basic demographic information about you, your insurance information, fee & cancellation policy, and the problems you want to address.
Couples Intake Form
This form provides some basic demographic information about you, your insurance information, fee & cancellation policy, and the problems you want to address.