Client Forms

It will save us time at our first meeting if you review and sign off on these forms, and bring them to your first session (if you are unable to, I have hardcopies on hand as well). Please scroll down for directions to my office.

INDIVIDUAL THERAPY

If you are seeing me for individual therapy – please complete the Individual Intake Form, and review/sign off on my Office Policies as well as HIPAA Notice of Privacy Practices. I will review the basics when we meet and you can ask me any questions you have.

Intake for individuals

Office policies and informed consent

HIPAA notice of privacy practices

Directions to my office:

10 Technology Way, #4E1A

Nashua, NH 03060

• For in person meetings, please read the following directions to my office as GPS can sometimes misguide people:
• The address of my office itself is 10 Technology Way in Nashua, it is a big brick and white building called Millyard Office Park.
• If you are coming from Route 3, take exit 6 onto Broad Street and head toward downtown Nashua (away from the KOHL’s plaza).
• You’ll go through 2 sets of lights — you’ll see Mobil and Sunoco stations on your right, and then there will be a set of lights and a bigger intersection with a lane to take a right and 2 other lanes.
• Take that RIGHT — the “Broad Street Parkway” (if you go by the Dunkin Donuts on the right you’ve gone too far)
• You’ll be on that road for about a mile until you hit a small set of lights — my building is just to the right of that (you’ll see it, it’s a big brick and white building called “Millyard Office Park” or “Millyard Technology Park” (it has both names) )
• Take the first right at the lights toward the building.
• The parking lot is in the back of the building, so just drive down the hill that loops behind the building to the back.
• Once you get to the entrance, go up the flight of stairs, make a left and you’ll see the elevator on the right. Take it to the 4th floor and my office is directly across from the elevator on the corner, slightly to the left.
• If you need a wheelchair accessible entrance with no stairs, DO NOT drive all the way to the back of the building — but park in a handicap spot that you will see shortly after turning into the driveway. Upon entry to the building, make a right, and go down that corridor until you see the elevator.
• Take it to the 4th floor and my office is directly across from the elevator on the corner, slightly to the left.
• If you happen to be early and my door is closed please make yourself comfortable at the table outside, it may mean I am in session as it’s just my private office in there.