Download Forms

Click the link(s) below to download:

1) Application for Services
This is filled out before you come see me at our initial session.

2) Information Release
This is filled out if you want me to have contact with any of your doctors, friends or family.

3) Discharge Form
This is to be filled out when you no longer need my services.

4) HIPPA Act for Client Right to Privacy

Call 954-547-4070 reserve your appointment!