Consent For Treatment Please print this form
Couples’ Mission Statement: Building the relationship of your dreams
If you fail to cancel a scheduled appointment we cannot use this time for another client and you will be billed for the entire cost of your missed appointment. We ask that you give this office 24 hour notification of any cancellation. A full fee is charged for missed appointments or no shows unless due …
If you're a new client, please complete the following forms and bring them to your first therapy session.
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:
Note: To download Adobe Acrobat Reader for free, click here .
Click here to view and print forms for your appointment.Click Here