Helpful 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:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form HIPAA Form
Limits of Confidentiality/Therapy Cancellation Policy TeleHealth Consent Form
Authorization to Disclose Information Form Notice of Privacy Practices
Credit Card Authorization

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

Primary Location

Address

16055 Ventura Blvd., Suite 555,
Encino, CA 91436

Phone

818.754-1526

Contact Us

My Availability

OFFICE HOURS

Monday

9:00 am - 9:00 pm

Tuesday

9:00 am - 9:00 pm

Wednesday

9:00 am - 9:00 pm

Thursday

9:00 am - 9:00 pm

Friday

9:00 am - 9:00 pm

Saturday

8:00 am - 4:00 pm

Sunday

Closed

OFFICE HOURS

Monday
9:00 am - 9:00 pm
Tuesday
9:00 am - 9:00 pm
Wednesday
9:00 am - 9:00 pm
Thursday
9:00 am - 9:00 pm
Friday
9:00 am - 9:00 pm
Saturday
8:00 am - 4:00 pm
Sunday
Closed