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Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.  If it's more convienent, you may also send them via email prior to your session or call and we will complete the intake over the phone together. 

If you would like me to coordinate care with another provider (for example, a counselor, therapist, your psychiatrist, primary care physician, etc.), complete this form to authorize release of art therapy information:

I also have a form to consent to display your work for research, marketing or community exhibitions which I will provide at our session if you would like to do so. 

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

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Helpful Forms

Click here to view and print forms for your appointment.