Location

Living in the time of Covid-19 means that currently I am operating fully online. I still maintain an office space but am not planning to return to office at this time. 

My practice is located at 4877 Chambliss Ave, Knoxville, TN 37919. This new location houses other psychotherapists and is located about 2 miles West off of Sutherland Ave. Check out the google maps link below.

4877 Chambliss Ave, Knoxville, TN 37919 (Click the address for a pop up google map image).

Forms

Please arrive at least 15 minutes before your scheduled appointment time to complete paperwork. If you prefer to complete paperwork prior to the day of, I’m including copies of the forms here so that if you have access to a printer and want to take a look through these earlier and bring them in, please do so. We will review them in your first session. If you are coming as a couple or family, please have each family member sign all the forms. If you are bringing in a young person (under 18), generally, a parent will need to sign some of the consent forms. I do prefer the adolescent fill out as much of the intake on their own as possible so that I can understand the issues from their perspective. If there are any forms you feel uncomfortable with or don’t understand, please highlight that part and we will talk about it first. If you find that I have arranged a form in such a way does not feel affirming to any of facet of your identity, please let me know and I will be happy to review the form and make changes. 

 

Please try to print them double sided if possible. 

  1. Intake: Complete to entirety. This helps me understand what’s bringing you in and your history.
  2. Counseling Agreement: Please read carefully and bring any questions about late cancellations or other policies.
  3. Assignment of Benefits Release: Only complete if you have health insurance and plan to have me bill your insurance. This form is required for me to bill insurance. *I will also ask for a copy of your insurance card.*
  4. Notice of Privacy Practices: Required by all clients to review and sign. Please bring any questions to your first session.
  5. Client Billing Information Form to be completed by all clients.
  6. Safety Plan: to be completed by all clients.
  7. Release for Information Exchange: to be completed to allow for me to talk to anyone about you (former therapists, doctors, etc).
  8. Telehealth Informed Consent: To be completed in order to allow for the flexibility of occasional Telehealth sessions.
  9. Several screeners for common issues: ACE-Score; PTSD_Screener; Generalized_Anxiety; Depression; OCD Sreener: Please click on each issue and complete the screener and bring in with you for your first session.