NEW CLIENT FORMS
Once you download, print, and complete the appropriate forms, you may send them via secure transfer by scanning the completed documents into your computer and using the button below. You will be taken to the Secure Document Transfer page of this website. Or, you may bring them in for your initial visit.
Couple New Client Packet
| Couples Counseling |
Individual New Client Packet
| Individual Counseling |
Telehealth Addendum Form
| Telehealth Consent Form |
OTHER HELPFUL FORMS
Couple Assessment - Ask me about taking the Gottman Relationship Checkup
Adverse Childhood Experience Inventory
| ace-score.doc.pdf |
Female Sexual Function Inventory
| fsfi.pdf |
Male Sexual Health Questionnaire
| mshq.pdf |
Sexual Symptom Assessment Scale - Evaluates problematic sexual behaviors.
| sexual_symptom.pdf |
Hyper Sexual Behavior Consequences Scale - Evaluates adverse consequences from sexual behaviors.
| hypersexual-behavior-consequences-scale.pdf |
Release of Medical Information
| dr_release_of_information.pdf |