Client Forms

Client Forms

NEW CLIENTS

If you are new, please call my office at 708-275-8425 to register an account on our secure client portal (therapyappointment) to start the intake process. I will have available the intake forms to complete in your client portal. Please fill out the forms and submit completed documents through the client portal before you arrive (office or virtual). Allow yourself 20-30 minutes to complete.

*If you are coming for couples or family therapy ALL persons must complete the forms individually. 

CURRENT CLIENTS

If you are a current client and would like to schedule a future appointment or cancel an existing appointment please call my office at 708-275-8425.

AUTHORIZATION FOR RELEASE OF INFORMATION

If you feel that you would like to collaborate your session with another provider, please contact me to obtain a Authorization for Release of Information form.

 

HIPAA Notice of Privacy Practice