Make a Payment
To make a payment with your credit card, just fill out the amount below and click ‘Make a Payment’. You’ll be taken to PayPal’s Website, where you can complete the payment to me safely and securely.
Helpful Forms
If you’re a new client, please complete the following forms and bring them to your first therapy session.
- Client Intake Form
- Information, Disclosure, and Consent Form
- Insurance Benefits Verification Form
- Confidentiality & HIPAA Practices Form
- Consent to Correspond Electronically Form
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.
Appointment Request
To schedule an individual counseling appointment or to obtain additional information about my services, please fill out the form below or give me a call.
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