Helpful Forms

These are the forms I use in my practice.

  • Registration Form
  • Client Data Sheet
  • New Client Information (Consent Form)
  • Consent to Use and Disclose Your Health Information
  • Notice of Privacy Practices

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

/userfiles/910176/file/Client Registration Form Paragon.pdf

/userfiles/910176/file/Client Data Sheet2.pdf

/userfiles/910176/file/New Client Brochure Final May 2020 pdf.pdf

/userfiles/910176/file/Form 23-NPP Consent Form ELW(1).rtf

/userfiles/910176/file/Notice of Privacy Practices Short.doc

/userfiles/910176/file/Authorization to Disclose Info.pdf

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

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