These three (3) forms need to be completed before therapy can begin.  Please download them, complete them, and return them to me via fax at (949) 756-9998 or when you come in for your first appointment.  Or, if you prefer, you may fill them out in person when you arrive at the office:
 

• Disclosure Statement & Agreement for Psychotherapy Services
• Confidential Information
• Acknowledgment of Receipt of Notice of Privacy Practices (please sign after you read the "HIPAA Notice" on this website).

Please complete these forms as needed:

• Insurance Information (please complete if you wish to use insurance to pay for services).
• Debit/Credit Card Authorization (please complete if you wish to use your debit or credit card to pay for services).

• New Psychotherapy Client Questionnaire

 
Please complete this form if you would like me to coordinate care with outside parties (e.g., psychiatrist, physician, etc.):

• Authorization to Exchange Protected Health Information

 
This article will help familiarize you with Psychodynamic Psychotherapy.  Please read it at your leisure:

• An Introduction to Psychodynamic Psychotherapy

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