Please electronically fill out all 8 pages of the following document.  This information is required in order to begin counseling.

Doc 1 – General Intake-Insurance Form

Doc 2 – Consent or Authorization for Release of Confidential Information

Update Form – Insurance Information and Credit Card

The following links lead to resources I often reference in session.

TICES Log (for EMDR)

Modified Karpman Drama Triangle

Trauma Model Spectrum of Emotions

Wheel of Power and Control

The following documents are for specific insurance companies only. Please do not fill these out unless directed to do so by your therapist or our office staff.

Health Advocate EAP Statement of Understanding

The following documents should only be filled out if asked to directly by your therapist or the office staff.

Document 2- DES2

Document 3- Young Schema Quest.


Safe Space MP3