New Client Paperwork

If we agreed to schedule an appointment, download and fill out the forms below and bring them with you to your initial session. I will need them completed and signed before we can get started.

While my billing service will file claims with all insurance companies, I ONLY PARTICIPATE ON PANELS with Anthem, Anthem Healthkeepers, and MHNet. Other companies will pay some part of my fee, but the balance will befall you. Be sure to examine the amount of your deductible, co-pay, and the percentage your insurance company will cover for clinical psychologists.

Client Information Form

HIPAA Signature Form

Financial Terms Form