If you're a new client, please complete the following forms and bring
them to your first therapy session.
- Psychotherapy Intake Form
- Limits of Confidentiality/Therapy Cancellation Policy
- Insurance Pre-Authorization Form
| Psychotherapy Intake Form
| Limits of Confidentiality/Therapy Cancellation Policy
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
| Authorization to Disclose Information Form
- Minnesota Board of Marriage and Family Therapy - Client Bill of Rights
MN Board of MFT - Client Bill of Rights
Note: To download Adobe Acrobat Reader for free, click here .