Helpful Forms

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

  • Assessment Form
  • HIPAA / Privacy Notice

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

  • Release of Information Form

If you are a couple wanting to pursue counseling services together, please complete the following form.

  • Gottman Couples Form

I have been told by my clients that sometimes the forms take a minute to appear on their computer, please be patient.

Adult Assessment Form

 

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

Contact Me

Channahon

Joliet

Morris

Availability

Primary

Monday:

8:00 am-9:00 pm

Tuesday:

8:00 am-9:00 pm

Wednesday:

8:00 am-9:00 pm

Thursday:

8:00 am-9:00 pm

Friday:

8:00 am-9:00 pm

Saturday:

8:00 am-5:00 pm

Sunday:

Closed