Forms

Below is a directory of the forms that I have new clients read and sign.  The information release form is not always needed — it’s provided so you can see what the form looks like if you’ve had a doctor or therapist in the past whom I should talk with.

I have forms below for out-of-pocket/out-of-network clients and also for Medicaid/Medical Assistance/PAC clients.

Out-of-Pocket Clients (Private Pay, Out-of-Network)

It would be helpful, but not at all required, if you bring these with you already completed to our first session.  Some people like to meet me first before filling out forms.  We should have already spoken via email or phone and agreed to an appointment before you fill these out.

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Medicaid Clients (Medical Assistance, PAC)

Please bring these completed forms with you or be prepared to complete all of them at your first session.  You may wish to arrange to arrive early to work on these in the waiting room prior to our first session (tell me you want to do this before coming early).  We should have already spoken via email or phone and agreed to an appointment before you fill these out.