Forms
Intake for Couples
Couples Information (Instructions, please print two of these forms. Each of you to complete and bring with you to the first session .) This is optional, however, recommended.
Notice of Privacy Practices
Receipt of Privacy Practices
If you would like for your therapist to speak with anyone about your progress or treatment, you will need to complete this form and either bring it with you, or fax it to (818) 783-2927.
Authorization For The Release Or Exchange Of Information
If you plan to use your insurance, please complete the following form and bring it with you to the session. Please remember that I am not on any panels which means I would be an “Out- of- network” Provider.
Insurance information (digital form)
In Person session consent during COVID-19