Helpful Forms

Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

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 health care professionals and would like to make referrals to us, please complete the Referral Form and fax it to (203) 248-5312. Thank you.

Please note, this referral form is for physician, case manager, social worker, hospital, or other healthcare professionals use.