Forms

NEW PATIENT PAPERWORK
You may either print these out and bring them with you to the first session or arrive 15-30 minutes early for your first appointment to fill them out in the office. Every new patient should fill out the disclosure statement and patient history. If you feel any of the specifi screenings apply to you, please fill those out as well.

Professional Disclosure Statement
New Patient History

Specific Screenings
PTSD Checklist/Screening
Severity of PTSD Symptoms
Dissociative-Experiences-Scale-II
Mood Disorder Questionnaire (MDQ)
Patient Health Questionnaire-9 (PHQ-9) Depression Screening

Group Therapy
If you are attending group therapy rather than individual, please fill out the following:
Professional Disclosure Statement
Brief Group Therapy Screening

 

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