Forms (Old)

Below you will find the forms that need to be completed before your initial session. I prefer you to download, fill out, and return the forms via email to (don’t forget to sign them!). However, you are also welcome to print a copy — if so, please fax these to me at (888) 972-6250, or remember to bring these copies with you to my office. If you prefer, you may arrive 15 minutes early to fill out these forms. The forms can be found on a clipboard in the waiting room.

Clients wishing to communicate via video calls, please complete this form:

  • Electronic Counseling Informed Consent – pdf – word doc

For yoga private sessions, you will only need to complete the following form:

  • Agreement of Release and Waiver of Liability – pdfword doc

These additional forms do not require you to fill anything out. I am required by law to provide you with the Client Agreement/ Notice of Privacy Practices and Social Media Policy for you to read. The Release of Information form is only needed if you wish me to share your confidential information with another professional.

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