Forms

I provide individual, family, marital and group psychotherapy for a wide range of disorders and specialize in the treatment of addictive disorders. co-dependence and trauma. I have published two books that explain the impact of alcoholism and other substance abuse disorders on the family and also describe a path toward recovery. When you begin treatment, there is, of course paperwork to do. Below are forms for you to review, download and complete if you desire.

Forensic Evaluation Form

Consent to Treatment: This document outlines the benefits and risks of treatment and other important issues such as fees, insurance reimbursement, cancellation policies and so forth.

Maryland Notice Form: This form provides information about your privacy rights under the Health Insurance Portability and Accountability Act.

Acknowledgement of Receipt of HIPAA Information: This form acknowledges that you have received information about your privacy rights.