Forms / Formulaires

Informed Consent for Therapy
(Consentement éclairé au traitement)

Gives permission for psychological treatment and outlines your rights and responsibilities. 

Informed Consent for Telepsychology

(Consentement pour services à distance)

Required for remote sessions. Must be signed before any virtual consultation. 

Emergency contact for Telepsychology

(Personne à contacter en cas d'urgence pour services à distance)

Needed to comply with telehealth safety protocols. 

Notice of Privacy Practices 
Describes how your personal health information is handled in compliance with the Health Insurance Portability and Accountability Act (HIPAA),
législation américaine visant à protéger les informations confidentielles relatives à la personne et à sa santé physique et mentale. 

Therapy Intake Form
(anamnèse pour un client en thérapie)

Required for all new therapy, hypnotherapy, or coaching clients. Complete before your first session. 

Authorization for Release of Information
​(Autorisation écrite de partage d'informations confidentielles)
Optional form if you want me to coordinate care with your physician or other providers.