Accessibility View Close toolbar

Forms

If you're a new client, please print and complete the following forms and bring them to your intake, your first therapy session.

MPP Client Psychotherapy Intake Form

and breathe

MPP Consent to Treat a Minor Authorization Form

HCFA Insurance Billing Authorization

MPP Clinical History Form

MPP Adult Symptom Screeners

MPP Child/Adolescent Symptom Screeners


Please refer to the following forms for your information.  You may print and keep a copy of these policies.

MPP Cancellation Policy

MPP Fee Schedule

MPP Notice of Privacy Practices


If you would like us 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


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

Please feel free to contact me!

LOCATIONs

Office Hours

Primary

Monday:

8:00 am-7:00 pm

Tuesday:

9:00 am-7:00 pm

Wednesday:

9:00 am-7:00 pm

Thursday:

9:00 am-7:00 pm

Friday:

9:00 am-7:00 pm

Saturday:

Closed

Sunday:

Closed