Appointment Request

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

If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

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Appointment Form

To schedule an individual, children, couples, marriage or family therapy appointment, or to obtain additional information about any of these counseling services, please fill out the form below or give us a call at 718-426-8110.

 

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Please do not submit any Protected Health Information (PHI).

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