Forms

Please read the New Client Documents. Print and fill out the three that require a signature and bring to your first appointment.

Contact Information

Professional Disclosure Statement

Notice of Privacy Practices

PDS and NPP Acknowledgement Form

Informed Consent

Let's Connect

Contact me to see if I may be a good fit.

If this is a medical emergency, please call 911.

We highly respect and safeguard your privacy and will never disclose your email address and message to anyone. You acknowledge that the contents of this form will be sent via email and will be stored on servers located in the United States, and understand that you should not use it to provide any personal health information.

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My Office

1020 SW Taylor Steet, Suite 730
Portland, OR 97205