Child (Under 18) Intake Form
Child (Under 18) Intake Form
To help me prepare for your child's first session, please complete the intake form after you have scheduled an appointment and at least one day before the initial visit. Thank you.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that protects sensitive patient health information. Any information you submit here is protected by this law and will never be shared.