Helpful Forms Montclair, NJ


If you're a new client, please download, print, and complete the following forms and bring them to our first therapy session. 

  • Adult or Child Intake Form (*Note: Child intake form for 14 y/o and younger.  otherwise, download and print adult form and bring it to our first session)
  • Client Contract for Treatment
  • NJHIPPA Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, teachers etc.), download and print the PDF file: "Authorization for Release of Information" form below

  • Authorization to Disclose Information Form


Adult Client Intake Form
Child Intake Form
Client Contract for Treatment

Authorization to Disclose Information



Note: To download Adobe Acrobat Reader for free, click here.

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