Forms
For therapy clients, please fill out and send these forms back to me by the night before our first session.

kl_intake_paperwork_2021.doc | |
File Size: | 73 kb |
File Type: | doc |

kl_hipaa_consent.docx | |
File Size: | 13 kb |
File Type: | docx |
Therapy clients, please download and read HIPAA and my Good Faith Estimate Notice.

hipaa.pdf | |
File Size: | 76 kb |
File Type: |

good_faith_estimate_notice.docx | |
File Size: | 405 kb |
File Type: | docx |
If I am in-network with your insurance plan and you plan to use your benefits, please fill out and send these forms back to me prior to our first appointment. There is no need to complete these forms if you plan to file for out-of-network benefits.

insurance_verification_form.docx | |
File Size: | 506 kb |
File Type: | docx |

insurance_benefit_information.docx | |
File Size: | 14 kb |
File Type: | docx |
For students, please fill out this intake form and send it back to me by the night before our first meeting.

kl_teaching_intake_paperwork_2021.docx | |
File Size: | 21 kb |
File Type: | docx |
Once our first appointment is scheduled, please let me know whether you plan to use insurance to pay for our sessions. If you are planning to pay out of pocket, I will provide you with a Good Faith Estimate of the costs of your care before our first meeting.