If you're a new client, please complete the following forms and bring them to your first therapy session.
- New Client Information Form
- Informed Consent
- Medication Log
- Burns Anxiety Inventory
- Burns Depression Checklist
- Mood Disorder Form
- Michigan Alcoholism Screening
- Adult Psychosocial History and Evaluation
- Patient Contact Authorization Form
- Outpatient Service Agreement
- HIPPA 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:
Note: To download Adobe Acrobat Reader for free, click here.