Forms


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:

  • Authorization to Disclose Information Form

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

Location

Availability

Monday:

Closed

Tuesday:

9:00 am-8:00 pm

Wednesday:

9:00 am-8:00 pm

Thursday:

9:00 am-8:00 pm

Friday:

9:00 am-8:00 pm

Saturday:

9:00 AM-5:00 PM

Sunday:

Closed