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"Finding a path to a better tomorrow." 

Forms / Payments

Helpful forms and payments.

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Intake Form
  • Disclosure Statement & Agreement for Services
  • Notice of Privacy 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:

  • Release of Information Form
The above forms are in a .pdf format.  If you do not have a compatible document viewer please follow the below link to download a free one.
Making Payments

To make a secure payment with your credit card, please click on the link "Payments through PayPal". You'll be taken to PayPal's website, where you can complete the payment to me safely and securely.

Insurance Information

We may be able to direct bill various insurance companies for you.  If your insurance company is not listed below your treatments may still be covered.  Check with your individual insurance company.

Current Insurance Partners

  • Anthem / Blue Cross Blue Shield of CT
  • Empire Blue Cross Blue Shield of NY
  • Empire - United Healthcare
  • United Healthcare
  • ConnetiCare
  • Oxford
  • Harvard Pilgrim
  • Cigna Behavioral Health
  • Husky CT / Medicaid