The following documents include my Disclosure Statement, required by the Colorado Department of Regulatory Agencies (DORA), as well as my practice policies, client agreements, consent forms, and privacy practices (HIPAA) in accordance with federal and state laws. These documents are available for you to download and save.

After you schedule an initial appointment with me, you will be able to read and electronically sign these documents and consent forms in the Client Portal. If you understand and agree with my practice policies and consent to treatment, sign these documents prior to our initial visit. We will discuss these documents during our initial visit so that all your questions are answered.

Practice Documents

  • The Colorado Department of Regulatory Agencies requires psychologists to provide all new clients a Disclosure Statement. Click on the link to view.

  • The HIPAA Privacy Policy. Click the link to view

  • Informed Consent for Telepsychology describes the potential benefits and risks of psychotherapy using video-conferencing versus in-person psychotherapy

  • Credit Card Authorization Form (revised 02-18-2023) required to schedule an initial appointment.

  • WestSide Behavioral New Client Information Form. Completion of this form is required for clients with Kaiser Permanente Healthcare benefits referred through through Westside Behavioral