Forms

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

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

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Contact Me

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Champaign Office: 201 W. Springfield Ave., Suite 1002 Champaign, IL 61820
Madison Office: 6314 Odana Road Suite 23 Madison, WI 53715