Forms for New Clients

Please complete, scan, and email me the completed forms at least two business days before our first scheduled appointment: [email protected] Thanks!

 

 

I have a 24-hour cancellation policy.

Please provide at least 24-hours’ notice to reschedule an appointment. If you must reschedule a Monday appointment, please contact me by 5p on the preceding Friday.

Insurance does not pay for late cancellations or missed appointments.

Insured clients are charged $75 for missed initial evaluations or those canceled with less than 24-hours’ notice and $50 for missed one hour therapy sessions or those canceled with less than 24-hours’ notice

Self-pay clients are charged $100 for missed initial evaluations or those canceled with less than 24-hours’ notice and our agreed upon hourly rate for missed one hour therapy sessions or those canceled with less than 24-hours’ notice.

Click the links to download the forms

Please remember to scan and email me the completed forms at least 48 business hours before our first appointment. Email: [email protected]

Please feel free to contact me with any questions about these forms or
anything else.  Ethical and legal guidelines prohibit me from
meeting with new clients without these completed forms. 
Thank you for your cooperation.