If you're a new client, please complete the following forms and bring them to your first therapy session.
- New Client Registration Form
- Attachment Form
- Individual History Form, or if coming in for couples counseling
Coupes Intake Form
Please review the Notice of Privacy Policies, either online or you may print the policies file below.
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:
- Release of Information Form
|New Client Registration Form||Notice of Privacy Practices|
|Individual History Form||Release of Information Form|
|Couples Intake Form||Attachment Form|
Note: To download Adobe Acrobat Reader for free, click here.