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

• Client Intake Form
• Limits of Confidentiality/Cancellation Policy Form
• Client Contract
• Letter of Introduction to Client
• HIPAA

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

• Consent to Release Information Form

Client Intake Form
Confidentiality and Cancellation Policy
Consent to Release
	Use the Following Forms for Services in Sonoma
Two-Way Release	For services in Sonoma: Allows the transfer of information between professionals.
Client Contract	For services in Sonoma: Client commitment and responsibilities.
Consent to Treat a Minor	For services in Sonoma: Authorization to provide services for a Minor.
Consent for Child's Parent	For services in Sonoma: Authorization to Obtain Confidential Information for a Minor.
Letter of Introduction to Client	For services in Sonoma: Supervisor's Letter of Introduction for the Psychological Assistant.
HIPAA	For services in Sonoma: Explains the Heath Insurance Portability and Accountability Act of 1996.

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