If you're a new client, please complete the following forms and bring them to your first therapy session.
- New Client Information Form
- Spanish New Client Information Form
- Limits of Confidentiality/Therapy Cancellation Policy
- Non-Custodial Parent Consent to Treatment
- Tele-Counseling Consent Form
- Credit Card Authorization Form
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:
If you are a Kaiser client:
If you are a Ceridian EAP client:
- Ceridian Spanish Statement of Understanding
- Ceridian English Statement of Understanding
- Ceridian English Treatment Waiver Form
- Ceridian Spanish Treatment Waiver Form
Note: To download Adobe Acrobat Reader for free, click here.