Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

Adult Forms:

• Adult Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
• Insurance Billing Form 
• MBC Policies

Child/Adolescent: 

• Child Adolescent Psychotherapy Intake Forms
• Limits of Confidentiality/Therapy Cancellation Policy
• Insurance Billing Form 
• MBC Policies
  
  

Forms for Group Therapy:

• Mindful Stress Management Registration Form
• Therapeutic Yoga Intake 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:

• Authorization to Disclose Information Form

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