Client Resources
Forms
New Client Packets (PDF Form)
New Client Packets (PDF Form)
-
Individual Therapy Packet for an Adult
-
Individual Therapy Packet for a Conserved Adult
-
Individual Therapy Packet for a Child or Minor Adolescent
-
Individual Therapy Packet for a Minor Adolescent (14+) consenting for self
-
Couples Counseling for two Adults
-
Joint Therapy for an Adult and a Minor Child
-
Joint Therapy for two Adults
-
Joint Therapy for a legal Adult and a Conserved Adult
-
Family Therapy
Individual Forms (PDF Forms)
-
Informed Consent and Confidentiality Agreement
-
Intake for Mental Health Service for an Adult
-
Intake for Mental Health Services for a Conserved Adult
-
Intake for Mental Health Services for a Minor
-
Intake for Mental Health Services for a Couple
-
Intake for Mental Health Services for a Family
-
Consent for Treatment for an Adult
-
Consent for Treatment for a Conserved Adult
-
Consent for Treatment for a Minor
-
Privacy Practices
-
Release of Information
Telehealth Portal
Doxy.me Virtual Office
Submit a Payment
The fee for service is $150.00 for a 50 minute session, although we may take up to the full hour.
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.
Credit card, check (payable to IGNITE), cash, PayPal (info@ignitefutures.org) and Venmo (@ignitecollective) are accepted.