Forms

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

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:

Forms for clinical supervision:

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

Please feel free to contact me!

LOCATION

2133 NE Broadway #303 Portland OR 97232 P: 503-568-1201

Availability

Monday, Tuesday, Thursday, Friday:

10 to 6

Wednesday, Saturday, Sunday:

Closed