To minimize paperwork at your initial consultation, please complete the following forms and send them via email to your therapist/evaluator (if meeting remotely) or print/bring them to your first appointment.

PsychoTherapy Forms

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For All Patients

• Patient Acknowledgement​

• Please read our 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 access this information.
• COVID-19 Waiver for In-Person Psychotherapy Services
• To enroll in our Billing Service create an account with Nirvana Health: client.meetnirvana.com

For Adult Patients

• Adult History and Checklist of Concerns

• Psychotherapist-Patient Services Agreement
• Consent to Release Information Form

​For Child and Adolescent Patients

• Child/Adolescent History Form
• Psychotherapist-Patient Services Agreement
• Minor Consent​

ASSESSMENT FormS

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For All Patients

• ​Psychological Assessment Service Agreement
• Patient Acknowledgement​

• Please read our 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 access this information.​
• ​COVID-19 Waiver for In-Person Assessment Services