If you are a new or returning client, please complete the following forms and bring them to your first therapy session.
- Intake Form- Please fill out the appropriate form ie. Adult, Adolescent, Couples or Child Intake Form.
- Insurance Form This forms can be emailed ( [email protected] ) or faxed (907-247-5001) before your therapy session, so that I can inform you of any out of pocket expenses.
Please note that all fees have been raised by $5, except the Intake Fee.
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
|Adult Intake Form|
|Adolescent Intake Form|
|Child Intake Form|
|Authorization to Disclose Information Form|
Note: To download Adobe Acrobat Reader for free, click here .