Helpful Forms

If you're a new client, please complete the following forms and bring them to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

 

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

  • Consent to Release Information Form

Client Intake Form
Confidentiality and Cancellation Policy
Release of Information
What is Response to Intervention? This article explains more about the RTI model.
Homebound Instruction This paper pdf file from the Virginia Department of Education explains current homebound rules. How long can your child receive needed services? What information do you need to provide? What about the IEP?
release

Note: To download Adobe Acrobat Reader for free, click here.