Practice Forms

All of my practice forms are available within the Client Portal.

If you are unable to complete the forms online, you may either download, print and complete the following forms prior to your initial appointment or arrive 10-15 minutes early for the appointment and complete them at that time.


Notice of Privacy Practices


Authorization to Release Information


Explanation of Services

Financial Agreement

Client Demographics

My Practice


21 West Central Ave
Delaware, Ohio 43015

Open Hours

Mondays: Telehealth
Tuesdays: 10am-7pm
Thursdays: 9-6pm