We hope that you and yours are staying healthy and safe. As part of the growing concern surrounding coronavirus (COVID-19) we are providing HIPAA compliant Tele-Counseling services. This will allow us to provide services to you without you having to leave your home. Tele-Counseling services are covered by most insurance providers with the same copay or deductible as if you came into the office. The Online Counseling tab below has been added to our website to provide additional information.

If you have additional questions, please contact our office.

 

Healthcare Forms

Health Care Forms: to be filled out prior to your appointment

To fill out on line: Click on the download button of the appropriate form below. An interactive form will be downloaded to your computer. Fill this out, save and email to us prior to your appointment. If you do not have a digital signature, just send it unsigned and sign it at the time of your appointment. (see more details below)

To fill out by hand: If you prefer, you can download it to your desktop, print it out on your home printer, and fill it out by hand. You can email, mail, or bring it with you to your appointment.

Please choose and download the appropriate form below:

New Patient  Intake Packet

If you are a new patient, please download this form on your computer by clicking on the “download” button below.

Email it to us at:  or Fax  to us at 941-952-9705 

Child Intake Forms

If you filling this out for your child, please download the registration and the consent form on your computer by clicking on the “download” button below.

Email it to us at:  or Fax  to us at 941-952-9705 

Forensic Intake Forms

If you filling this out for your child, please download this form on your computer by clicking on the “download” button below.

Email it to us at:  or Fax  to us at 941-952-9705 

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.


Schedule Appointment

Start your new path in life and be the change today!

Click Here

Helpful Forms

Click here to view and print forms for your appointment.

Click Here