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Client Forms


Client Questionaire

Basic Intake information before first session - please complete and email: to [email protected] or fax to: 951-461-9199

Client History Form

If you're a new client, please complete the following forms and email, fax , or bring them to your first therapy session. This saves valuable session time and provides me with information in advance of your appointment. (Email: [email protected] , Fax: 951-461-9199)

Release of Information Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information.