Helpful Forms

If you're a new individual client, please click on the following forms  to download them, fill them out, and bring them to your first therapy session.  I will also email or snail-mail you some instructions and a consent form that will help you figure out how to find my office, get buzzed in, get to me via public transport, or where to park.  .

Note: these forms below take some time to fill out, so please allow 2 to 2.5 hours to complete them.

Several are password protected, so you can open them with the password, fill them out and save them periodically as you fill them out, then send them to me encrypted.  That way your information is safe as it travels through the internet.  

The current password is Houston#2

Life History and Current Life Form:

Video sessions information and consent, emergency info 9-24

Intake forms w #'s, Dx, CUDOS, CUXOS, etc. BLANK   9-17-24H

ITWYL Electronic Communication Policy for Intake  [based on APAIT] 5-26-24

ITWYL w-o PW 2401 Intake Intro & 1st session handouts packet   9-17-24

ITWYL HIPAA-privacy-confidentiality Policy

Please contact me for the latest consent form for you.

• 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 .