Becoming a Client

For our mutual convenience, prior to your initial appointment, you can download, fill out and sign the following documents rather than completing them at my office.  If utilizing insurance, a copy of your card will be required on first visit.  Please verify “in-network” benefit prior to arrival.  All co-pays and deductibles are due at the time of service.

Required for All Clients:

For Your Reference

* Privacy & Policy

* Consent to Release Information: This is required for any 3rd party exchange of information

including phone calls, emails, release of counseling records. (Download as PDF)  or Click here to fill out the form online.

*  HIPPA (Download as PDF)

We Accept the Following Insurance Providers:

We are an in-network provider for Blue Cross x Blue Shield PPO, and Blue Crossx Blue Shield HMO

Credit Cards Accepted- Visa, MC, Amex