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Helpful Forms

If you're a new client, please complete the Client Coaching Intake Form and fax it to 413-487-3583 prior to your first session.
**NOTE:  Fax number may be incorrect on the form.  Please use the one above.  Thanks!

Client Coaching Intake Form  

If you would like me to coordinate care with another provider (for example, your therapist, primary care physician, etc.), complete the Authorization to Disclose Information Form and fax it back to me:

Authorization to Disclose Information Form  

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

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Helpful Forms

Click here to view and print forms for your appointment.

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