Next, please complete the Patient Information and Checklist of Concerns forms and bring them to your first session. This information will allow me to begin to understand you and what you are experiencing, and what you would like to achieve through therapy.
FOR PATIENTS UNDER 18 YEARS OF AGE:
Adolescent Information Addendum
• Child Checklist of Characteristics (for patients under 18 years of age please complete this form and the Adult Checklist of Concerns)
If you are authorizing me to obtain or release any information to another professional (e.g., your PCP, a prior mental health professional, your attorney) please complete the following form.
Thank you for your time in preparation of these forms. I am looking forward to working with you.
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