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:


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

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

!
!
!

Please do not submit any Protected Health Information (PHI).

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

Our Location

Address

5001 Hwy 190 Service Rd Suite C 2,
Covingrton, LA 70433

Phone

985-705-3395

Office Hours

Monday  

9:00 am - 5:00 pm

Tuesday  

9:00 am - 5:00 pm

Wednesday  

9:00 am - 5:00 pm

Thursday  

9:00 am - 5:00 pm

Friday  

9:00 am - 5:00 pm

Saturday  

Closed

Sunday  

Closed