To make the best use of your time, please print and fill these forms out prior to our first session.

Intake Form

Disclosure Statement

HIPAA Policies

***If you are coming to counseling and want to address trauma, which includes loss, divorce, rejection, negative core beliefs, traumatic events or history, sudden loss of job, damaging relationships, etc. please take the time to fill out the following Timeline Worksheet.  Please think of memories that you have an actual recollection of, not something you were told about or have just seen a picture of.  These memories can be good, bad or neutral.  The memory does not need a lot of detail (i.e. if you had a birthday party at age 8 with a piñata and lots of friends, you could just say "piñata party").  

Timeline Worksheet


If you have any trouble, please email me at