Forms

I use a HIPAA-compliant interface to set up appointments, send reminders, receive and send messages, and maintain records of our work together. If I have not sent you an invitation, you may create your Therapy Appointment account by clicking on the button below. If you have an account already, you can log in via this button.

Informed Consent for Treatment

Informed Consent for Telehealth

HIPAA Notice of Privacy Practices

Right to A Good Faith Estimate

NOTICE TO CALIFORNIA CLIENTS

The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of professional clinical counselors. You may contact the board online at https: www.bbs.ca.gov, or by calling (916) 574-7830.

NOTICE TO TEXAS CLIENTS

Anyone who wishes to file a complaint against a healthcare professional in this state may call the Health Professions Council toll-free complaint referral system: 1-800-821-3205. This automated, statewide number routes a complainant to the appropriate licensing agency. You may also learn more about the process at https://www.bhec.texas.gov/discipline-and-complaints/index.html