*Please email us to access online if you didn't receive it prior to your intake
Once your appointment is secured, you will be sent a secure link to complete the intake forms and consents. Please have this filled out prior to your intake appointment. The link will come from firstname.lastname@example.org email, so please check spam if you don't see it. If there are any custody legal arrangements, we will need a copy of those court documents (if applicable) sent to email@example.com. If you have a custody agreement, we must have a copy of this on file prior to seeing your child.
If you would like your therapist to coordinate care with another provider at any point during therapy (i.e,, psychiatrist, physician, other family member, step-parent, etc.), complete this form to authorize release of psychotherapy information:
The law protects the relationship between a client and a therapist, and information cannot be disclosed without written permission.
Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.