Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

• Client Intake Form
• Client Policies/Informed Consent
• Consent of Non-secure Forms of Electronic Communication
• Notice of Privacy Practices

If you are coming in for microcurrent neurofeedback please print and fill out the forms below.

• IASIS Intake Form
• IASIS Consent Form
• IASIS Arbitration Agreement

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:

• Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.