If you're a new client, please complete the following forms and bring them to your first therapy session.
For Kana's Clients:
All Clients must fill out the psychotherapy intake and consent forms below:
Please print the following form with the above forms if client is a minor.
If you would like me to coordinate care with another provider complete this form to authorize release of psychotherapy information:
For Clients of Kevel, Brian, Vanessa, Robert, Miriam, Angela or Aliasha
All Clients must fill out the psychotherapy intake and consent forms below:
Please print the following form with the above forms if client is a minor:
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:
For Clients of Wendy
All Clients must fill out the intake and consent forms below:
Please print the following form with the above forms
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:
For Clients of Rebecca
All Clients must fill out the intake and consent forms below:
Neurofeedback and Informed Consent
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:
For Clients of Amie
All Clients must fill out the psychotherapy intake and consent forms below:
Please print the following form with the above forms if client is a minor:
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:
Please fill out and print this Medical Questionnaire and bring to your first session.
Note: To download Adobe Acrobat Reader for free, click here.