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Forms

Helpful Forms

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

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

If you intend on using your medical insurance for coverage of the counseling sessions, please complete and return the form below to your therapist.  Please note that Pathway is considered to be “out of network” for a majority of insurance companies and you may be required to pay for the counseling services and submit for any reimbursement from your insurance carrier.

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