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:
If you're a new client, please complete the following forms and bring them to your first therapy session.
Client Psychotherapy Intake Form |
Limits of Confidentiality/Therapy Cancellation Policy |
Authorization to Disclose Information Form |
Maryland Child Abuse Reporting Information |
Insurance Information Form |
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