Below are a collection of forms as well as other documents often used in my practice.
EAP - New Patient Information If you are covered by an employers 'Employee Assistance Program' (EAP), please download this document and complete it. Bring the completed document to the first EAP appointment. It is necessary to obtain the EAP authorization number and provide the number of approved appointments.
"New Patient Information Packet" This downloadable PDF file includes (a) information about my practice, fees and a map to my office, (b) the "New Patient Information Form", (c) The New Patient Intake Qustionnaire". (d) The Informed Consent now required, (e) my Privacy Policies - also required. I'm aware all this paperwork may seem tedious but it is part of the required elements of your Patient Record. Please complete the forms prior to our first meeting so that we don't use the time to complete paperwork or use your appointment to obtain the information.
"Release of Information" This three page form must be completed if you want me to communicate with another medical provider or former therapist. If it seems confusing, feel free to ask me about it.
The Beck Depression Inventory (BDI) This self-scored questionnaire is probably the most commonly used measure of Major Depression symptoms. If, after scoring this questionnaire, your score is higher than 17, and your symptoms have lasted more than 4 days, you should consult a physician or psychotherapist immediatly. Bring the questionnaire to your healthcare provider.
The Adult ADHD Self-Report Scale
"Audit" Alcohol Use Screening Test
A Simple Overview of ACT Therapy
Other documents/articles often requested: (Other documents are on the blogsite.)
Depth of Committment This is a great article if you need a push.
Mood Scale I use this scale to track mood and to help me and my patient get on the same page. The horizontal increments can be in days, weeks or months - you decide.
Feeling words Some people genuinely have a difficult time identifying their feelings - this list can help. Just circle words that describe how you've felt in the past day, week or month.
The Sex Memo After YEARS of listening to women tell me how they feel about sex, I wondered if some men hadn't read the memo... so I wrote one.
Women and ADHD A womans experience of ADHD is different than men's. Find out how.
Teens and Marijuanna Pot is not so benign, particularly for teens; find out why.
Lying Lying is not a mental disorder - find out why we lie.
Resume'/CV For those needing a paper copy of my CV, use this link.