The Center of Connected Living FL

TIPTOE IF YOU MUST, BUT TAKE THE STEP!

Sometimes the smallest step in the right direction ends up being the biggest step of your life!

Complete your forms online through our complete secure and confidential online form intake.

Click Here for New Client Online Intake     Printable New Client Intake Form

Additional Information Regarding Insurance Practices

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:

Authorization to Disclose Information Form

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

 

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