PLEASE NOTE: My private practice is closed at this time, as I am currently working full-time as a staff therapist at UCLA Counseling and Psychological Services.


Before our first session, you will be required to complete a few forms. If you would like to review and complete them prior to our initial appointment, you can download and print them here.

New Client Information
This form allows me to get a better understanding of your personal situation and will guide us in developing a treatment plan that will help you achieve your personal goals.

Informed Consent for Psychotherapy Treatment and Office Policies
This form outlines my office policies, including limits to confidentiality, what you can expect from the therapy process, and my cancellation policies.

Credit Card Authorization Form
This form explains my billing/payment policies and explains possible communications disclosures when you pay for services a credit card or other electronic method.

Additionally, if you would like me to discuss your case with previous therapists, doctors, or other mental health providers, please complete this form:

Authorization for Release of Mental Health Information
Please complete this form if you would like me to receive and/or disclose confidential information to another treatment provider.

Note: All forms are in PDF format and require Adobe Acrobat to read. If you do not have this reader, you can visit the Adobe website to download the program for free.