Forms

If you are a new client, please complete the following forms and bring them to your first therapy appointment.

office-policy-and-consent-for-counseling-1.pdf

intake-form-2.doc.pdf

credit-card-authorization-form.pdf

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:

consent-to-release-confidential-information.pdf

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

Contact Me

Office hours / In Los Gatos currently; Tuesday - Wednesday In Aptos currently; Thursday

Call for an appointment: 408-566-3683

Monday, Friday - Sunday:

Closed

Tuesday - Thursday:

11:00 am - 7:00 pm