Helpful Forms

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

• Client Psychotherapy (Adult) Intake Form
• Client Psychotherapy (Child/Adolescent) Intake 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 the release of psychotherapy information:

• Authorization to Disclose/Exchange Information Form

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.

• Insurance Billing Information Form

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