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Client Forms

Client Forms: List

Good Faith Estimate

As of January 1, 2022, the federal government requires all health providers including therapists to furnish patients and clients with a “Good Faith Estimate” of what out-of-network treatment may cost, as an effort toward consumer protection through the “No Surprises” Act….

General Policies

Please download this document, read over, sign, and bring with you to your first appointment.

New Client Intake

Please fill out this confidential Google form before our first session so I can have some basic information about who you are and what we’re working on.

Credit Card Processing Permission

It is my policy to keep your credit card on file to charge after each session. I also have a 24-hour cancellation policy, and will charge your card if you do not contact me by phone 24 hours in advance of our scheduled session. Please print this off, fill out, and bring in with you for your first session.

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