FORMS NEW CLIENT INTAKE Please print and fill out the following patient information and medical history forms at your convenience. Patient Information Sheet HIPPA CONFIDENTIALITY FORM This notice describes how psychological and medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. HIPPA FORM START TO MAKE MEANINGFUL CHANGE TODAY Together we can make tomorrow brighter. CONSENT TO RELEASE INFORMATION This form when completed and signed by you, authorizes me to release protected information from your clinical record to the person you designate. RELEASE OF INFORMATION FORM INFORMED CONSENT FORM If you are interested in staying connected via phone or video chat for psychotherapy, please review and complete this form. INFORMED CONSENT FORM