The following forms are provided for download. However, when making your first appointment, I will send you a link to a secure portal where you will be able to electronically fill and sign practice documents.The Insurance Benefits Worksheet is provided to aid you in speaking with your insurance company about your out-of-network benefits. 

Notice of Privacy Practices

Social Media Policy

Release of Information (adult)

Release of Information (minors)

If you are a professional and would like to refer a patient, please fax the appropriate Release of Information Form (above) as well as a referral form. I have provided a referral form below for your convenience. Or, please feel free to use your own form.

Referral Form (for professionals)