healing
our parts

Virtual Psychotherapy Practice
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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.

Healing Our Parts

Virtual Therapy Services
Serving residents of:
• New Jersey
• New York

• Arizona
• Connecticut
• Florida

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All sessions are conducted online through secure telehealth platforms.

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We believe that therapy should be accessible. That is why all of our services are offered virtually.

healing
our parts

Virtual Psychotherapy Practice