Client Resources
Forms
​New Client Packets (PDF Form)
New Client Packets (PDF Form)
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Individual Therapy Packet for an Adult
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Individual Therapy Packet for a Conserved Adult
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Individual Therapy Packet for a Child or Minor Adolescent
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Individual Therapy Packet for a Minor Adolescent (14+) consenting for self
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Couples Counseling for two Adults
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Joint Therapy for an Adult and a Minor Child
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Joint Therapy for two Adults
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Joint Therapy for a legal Adult and a Conserved Adult
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Family Therapy
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Individual Forms (PDF Forms)
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Informed Consent and Confidentiality Agreement
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Intake for Mental Health Service for an Adult
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Intake for Mental Health Services for a Conserved Adult
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Intake for Mental Health Services for a Minor
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Intake for Mental Health Services for a Couple
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Intake for Mental Health Services for a Family
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Consent for Treatment for an Adult
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Consent for Treatment for a Conserved Adult
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Consent for Treatment for a Minor
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Privacy Practices
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Release of Information
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Telehealth Portal
Doxy.me Virtual Office
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Submit a Payment
The fee for service is $135.00 for a 50 minute session, although we may take up to the full hour.
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Currently, I do not accept insurance. However, those with out-of-network benefits will be provided with a receipt for services (commonly known as a "superbill") to receive reimbursement.
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Credit card, check (payable to IGNITE), cash, PayPal (info@ignitefutures.org) and Venmo (@ignitecollective) are accepted.