Helpful Forms
If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form
- Client Demographic and Insurance Information Form
- Patient Health Questionnaire (PHQ-9)
If you are experiencing any specific mental health issues, please print out and complete the corresponding assessment:
- Depression Scale
- Anxiety Assessment
- Anger Management Scale
- Stress Management Inventory
- Adult ADHD Questionnaire
- Child and Adolescent ADHD Questionnaire
The following forms need to be completed, signed and brought in to the first session in order for treatment to begin:
For those clients seeking Alcohol and/or Substance Abuse Treatment or have an Addiction Issue, please complete the following assessments:
- CAGE Alcohol Questionnaire
- Alcohol Use Disorders Identification Test (AUDIT)
- "I drink because"...worksheet
- Drug Abuse Screening Test (DAST-10)
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:
Note: To download Adobe Acrobat Reader for free, click here.