Below you will find two required forms and two others that may or may not be necessary depending on your particular circumstances.  Forms 1. and 2. are required of all clients. Form 3. is only required if the primary client is a minor, and Form 4. may be necessary if we decide together that it would be helpful to your therapy for me to consult with one or more of your other medical or mental health providers.

You may either complete these forms online and then print them out, or you may print them out and then complete them.

1.  Professonal Service Agreement: This form is required for all clients. It is a contract that defines the parameters of our theraputic relationship.

2.  Client Information Form: This form is required for all clients. Your completion of the form provides me with your address and contact information, basic medical and biographical history, and insurance information (if applicable).

3.  Consent to Treatment of a Minor: This form must be completed by a parent or guardian if the primary client is a minor. For more information about California laws pertaining to the treatment of minors click here or visit Teen Health Law.

4.  Telehealth Informed Consent Form: Telehealth allows me to diagnose, consult, treat and educate clients using interactive audio, video or data communication.

5.  Authorization for Release of Information: This form is required if you would like me to contact any of your other medical or mental health providers in order to obtain information that might aid in the theraputic process.

6.  Client Information Update Form: This form is necessary for RETURNING clients who have not been seen in the past six months.