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Please complete each of the following forms.

If coming into the office for your appointment, you may print each of the below documents, complete them and bring them to your first appointment.  Please also bring your insurance card, if you are planning to use insurance. 
    **If you are able to send these forms back to me via email prior to your appointment, this is most efficient, and appreciated!

If meeting with me over telehealth, please complete these forms and return them me via email, with a copy of your insurance card, prior to our schduled appointment.  Once I receive these forms, I will send you the Zoom link for our meeting. 

If you have any other providers you would like me to be able to coordinate care with, please complete one release of information for each provider.
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For youth between the ages of 13-18, it is very helpful to have a release to speak with a parent.  (For any concerns about this, I'm happy to discuss with both the teen and the parent, in our first session, how I typically balance incorporating parents in our work ,with the teen's emotional safety and confidentiality.  Please also see the section at the end of the Agreement for Individual Therapy for more on this topic.)

Thank you very much for taking the time to complete these.  I look forward to working with you.

© 2025  Michelle M. Johnson, PhD

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