36 Washington Square Washington Court House, OH 43160 USA
Please contact me for a consultation today.
If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Intake Questionnaire
- Agreement for Individual Therapy
- Agreement for Therapy with a Minor
- Notice of Privacy Form
- Confidentiality Statement Form
- Therapy Cancellation Policy
If you would like me to coordinate care with another provider, such as your psychiatrist or family physician, please complete the following form to authorize the release of your therapy information:
Note: To download Adobe Acrobat Reader for free, click here.