Assessment Forms

If you're a new client, please print and complete the following forms and bring them to your first therapy session. As email/internet may not be secure, I request that you do not send any completed forms electronically back to me.

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:

NOTE: For Tinnitus clients only: The Tinnitus Assessment Package "TAP" (forms and questionnaires) are located on the Services page of the HopeForTinnitus Website:

Note: To download Adobe Acrobat Reader for free, click here.

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Helpful Forms

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