801 East Main St

St Charles, IL 60174

Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

HIPPA

Service Agreement

Financial Policy

If you would like to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information

Release of Information

Note: To download Adobe Acrobat Reader for free, Click here.

Location

Availability

Primary

Monday:

By Appointment Only

Tuesday:

By Appointment Only

Wednesday:

By Appointment Only

Thursday:

By Appointment Only

Friday:

By Appointment Only

Saturday:

By Appointment Only

Sunday:

By Appointment Only