If you are a new patient, please complete the following online form prior to your first session.
Please note that you may download and complete this form as a PDF, if you do not wish to complete the form online.
Often times it is best to coordinate treatment with a Primary Care Physician or a Treating Psychiatrist for a continuity of care. Do you consent to coordinate care with the above Physicians?
Thank you for your submission!
Once we have had an opportunity to review your information, a professional licensed counselor will contact you.