Please complete the following two forms prior to your initial session:

  • Agreement for Service PDF
  • Patient Information PDF Word

The Agreement for Service includes a Notice of Privacy Policies and a Social Media Policy.

There are three options for completing and sending these forms:

  1. Use email ( to send the completed documents to me after filling them out on a computer or scanning them; if you use this approach, you should encrypt the Patient Information form with a password because it includes confidential information; leave the password on my voice mail so that I can open the document;
  2. Send the completed documents from your ProtonMail account to;
  3. Use another secure method by mutual agreement with me.

Two other forms are sometimes required. First, videotaping is integral to some types of therapy, but videotaping requires your consent. Use the following form for that purpose:

  • Consent for Videotaping- PDF

Second, in some cases it will be valuable, with your consent, to discuss your case with other professionals, such as your physician or psychiatrist. Use the following form for that purpose:

  • Authorization for Release of Information – PDF Word