Welcome

 

A few details:
I’m looking forward to our first session.
First you are both required to read the 4 items below so you can understand how my practice works.
Please click here to download.  (Go green, don’t print out.)

We have separated the patient request for confidential communications and signature lines from the information above, in the name of being green.

Please click here to download and print the signature pages. Please be sure to bring the completed signature pages to your first appointment.

There is an additional form, that is essential.

The Release Form For Media Recording.
You are required to check the first box which gives me permission to utilize the camera in session.  Note, I never work without a video camera.  It is an invaluable resource.  The second box is strongly suggested.  I am a faculty member of the PACT Institute and the second box gives me permission to my work reviewed by my mentor, Stan Tatkin, and fellow faculty members.  This helps me maintain the quality of therapy.  The rest of the boxes are optional.

Please click here to download and print this form. Please be sure to bring the completed forms to your first appointment.

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