5300 W. Atlantic Avenue Suite 408 | Delray Beach, FL 33484 (see map) | (561) 558-7815

If you’re a new client, please complete the following forms and bring them to your first therapy session.  A separate intake form should be completed by each member of the family.

Notice of Privacy Practice
Credit Card Authorization Form


Client Intake Form
Client Handbook


Please also read the Privacy Policies form which outlines privacy practices and your client rights.

Notice of Privacy Policies


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

Authorization to Disclose Information Form


Additional Forms

Assessment Intake Form

Developmental History for Gifted Pre-K-K Assessment Form