Helpful Forms

If you're a new client, please complete the forms sent to you using the email you provided to our office.
If for any reason  you are unable to keep your appointment please let me know as soon as possible.

In addition please bring your insurance card if applicable, and a photo ID to your first therapy session.

We value your time and hope completing these forms ahead of our session will be helpful.  My goal in asking questions is so we can start on your very first session.

HIPAA Information and Confirmation

Prior to your our appointment, please contact your Insurance Company regarding your insurance benefits.  This form will assist you in obtaing the necessary Information.  Prior to apointment this form MUST be sent to:
[email protected]

Insurance Verification

I provide counseling services to all of New Jersey, including (but not limited to):  Matawan NJ, Tinton Falls, NJ, Monmouth County, Red Bank, Middletown, Shrewsbury, Rumson, Navesink, Fair Haven, Holmdel, Colts Neck, Tinton Falls, Ocean Township, Long Branch, Eatontown, Asbury Park, Keyport, Hazlet, Lincroft, Marlboro, Manalapan, Highlands, Atlantic Highlands, Oceanport, Monmouth Beach, Spring Lake, Sea Girt, Manasquan, Oakhurst, Wall Township, Howell, Freehold, Aberdeen, Morganville, Matawan, Old Bridge and surrounding areas.

Contact Me



Evening hours available for online counseling



8:00 am-7:00 pm


8:00 am-7:00 pm


8:00 am-7:00 pm


8:00 am-7:00 pm


8:00 am-7:00 pm


8:00 AM-7:00 PM