Scroll down to find the paperwork requested:
Disclosure and Questions
To save time on our first visit, please click “Disclosure” and “Some Questions” to gain access to the pdf links below. Then please print, and complete the forms.
Please bring both “Disclosure” and “Some Questions” with you when you come in.
Please print, read and sign these documents:
Disclosure Statement, Methods and Rate Scale
Please print and complete:
Videoconferencing
In the event that we decide together to meet through videoconference, please click on the PDFs below, then read, sign and complete the “Consent for Telehealth.”
Please print, read and sign the following consent:
Please read the following information regarding Doxy.me below:
Instruction and Tips for Doxy.Me
Information Update and Rate Scale Update – For people already meeting with me – Only if requested
This is for people already meeting with me. About every two years, I increase the rate scale slightly for cost-of-living. At that time, I also ask to update information for my files. Please click on the PDF link below and print, complete and sign when requested.
Please print, complete and sign the form below.
Information and Rate Scale Updates 2022 – 2023
Authorization to Release or Request Information – Only if requested
If it has been requested that I speak on your behalf to another health professional, please print, read and sign the following release: