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Forms

If you are bringing in your child for psychological or psychoeducational assessment and/or therapy, please download and complete the following forms and bring them to our first appointment 15 minutes early please.


Limits of Confidentiality/Therapy Cancellation Policy

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.


Contact Me

Location

Availability

Primary

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-3:00 pm

Saturday:

Closed

Sunday:

Closed