If you're a first-time client, please review and complete the following forms, and send them to us via fax (1 503-765-1931), encrypted email or via USPS. If we are meeting in person you can bring them to your first session .
- Client Intake Form
- Limits of Confidentiality/Cancellation Policy Form
- Professional Disclosure Form
- Policy Information Form
- Informed Consent for In-Office Sessions
- Informed Consent for Teletherapy Sessions
- HIPAA Notice
- Good Faith Estimate Notice
- Anxiety Questionnaire
- Depression Questionnaire
- Adverse Childhood Experience Questionnaire
Professional Disclosure and Fee Agreement ![]() |
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Anxiety Questionnaire |
Depression Questionnaire |
Adverse Childhood Experience Questionnaire |
If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:
- Consent to Release Information Form
Release of Information ![]() |