Leonid_PasternakPlease print, complete, and bring each of the following forms with you to your first session:

  1. Client Information
  2. Checklist of Concerns
  3. Consent to Use and Disclose Your Health Information
  4. Confidentiality in Therapy
  5. Notice of Privacy Practices

If you wish to have the convenience of email or text reminders about upcoming appointments, please complete the following consent form: Consent for Transmission of Protected Health Information by Non-Secure Means. By signing this form, you give permission to your counselor to communicate via unencrypted channels such as email or text messaging. You may also wish to read our Communications Policy.