Thank you for scheduling your intake appointment.  I look forward to working with you.

Please complete this questionnaire prior to our appointment.

Your responses provide the necessary identifying information and authorization to file with your individual insurance carrier. They also will assist both of us in conceptualizing how I can best serve you.

Please complete this form:

Need Directions?
Click here for detailed directions to my home office.
Other Questions?
Please let me know any other questions you might have at or 919-360-0499..