Fees, Forms and Policies

Client Forms

If you are a new client or have changed significant information (name, address, phone, emergency contact, etc.), please print these forms, fill them out and bring them to your first/next session.

Client Information
Limits of Confidentiality
Fees, Insurance, and Payment
Cancellation Policy

For Group Participants

Please review and affirm these guidelines regarding group membership.

Group Membership Guidelines

Release of Information

If you are working with other health care providers and wish for information to be shared, please print, fill out, and bring this form to your first/next session.

Release of Information

Code of Ethics

As a Professional Counselor, I subscribe to the Ethics Policy of the American Counseling Association.

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