New Client Intake Form

New Client Intake Form

If you are booking your first appointment with me, please take a moment to complete my online intake form, or download it and bring it in with you. The questions on the form will provide a comprehensive view of your condition(s)/ complaints and help tailor a treatment plan to best help you.

If you use the online form, make sure you see a confirmation at the end that it was successfully submitted.  If any required fields are missing, it will not submit.

I also ask that you review my cancellation/rescheduling policy, which I will have you sign a copy of in my office, so we are on the same page.

Thank you, and I look forward to meeting you!