Ariella Soffer, Ph.D., NY Licensed Midtown Psychologist
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Initial Therapy Consultation Forms

​To minimize paperwork at our initial consultation, please review, print, and sign the forms below and bring them with you to the consultation.  


Adult History and Checklist of Concerns

Psychotherapist-Patient Services Agreement

Patient Acknowledgement

Please read my Notice of Privacy Practices to ensure that you are familiar with how psychological and medical information may be used and disclosed and how you can get access to this information.

Notice of Privacy Practices

Please complete a Release of Information form if you would like me to be able to consult with your other clinicians/providers regarding your treatment (for example, psychiatrists, former therapists, physicians, school personnel, agency representatives).

Consent to Release Information Form

For Child and Adolescent Patients:
Please print, sign and send or bring a copy of the Minor Consent and bring a completed Child/Adolescent History Form to the first session. 


Minor Consent
Child/Adolescent History Form

 ariella@drariellasoffer.com         (646) 300-5095

  • Home
  • Areas of Expertise
    • Areas of Expertise
    • Services for Parents
    • For Athletes
  • About
  • Forms
  • Schedule Now