Therapy for Kids & Teens

For more detailed information about my therapy policies, please read Simsbury Therapy – Therapy Treatment Policies. Also, please read Simsbury Therapy – Notice of Privacy Practices, which describes how medical information may be used and disclosed and how you can get access to this information. If you are interested in treatment for your child, feel free to call me and leave a short message, noting when would be a good time to call you back. We will first have a brief phone consultation (about 10 minutes, free of charge) that will provide us both with more information, and help us decide if we should schedule a first appointment.

Before your child’s first appointment, please fill out the following forms and bring them in with you. If there is anything that you’d prefer to leave empty, feel free to do so. If you’d prefer that I send you paper copies, please let me know when we speak.

Simsbury Therapy – Child & Adolescent Information Completing this form will save time in your first appointment, so that we can focus on assessing the issues and planning treatment.

Simsbury Therapy – Authorization for Release/Use of Information Please complete only the top part of this form (name, d.o.b., person/program, address…). Complete a separate form for your child’s SCHOOL, PEDIATRICIAN, PSYCHIATRIST, and any other past or present provider that you think will be a useful contact for me. Please leave the check-boxes and bottom sections empty. I’d like to discuss these with you before you sign.

In our first session, we will discuss all of the above. If you and I agree that we are a good match for treatment, I will ask you to sign that you have read and agree to my policies and privacy practices, and that you consent to treatment.