Intake Forms

Below are examples of the forms you will be provided with during your initial intake.

• Intake Form- Adult
• Intake Form-Minor
• Eating Disorder Assessment
• Agreement For Service/ Informed Consent For Minors
• Agreement For Service/ Informed Consent For Adults

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize the release of psychotherapy information:

• Authorization to Disclose Information Form

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