Let’s begin…

Thanks for making it this far. This is a simple application form to get us started. It will ask basic demographics, contact information and general questions related to what brings you here. If there’s a section that’s unclear, we will go over it at your first appointment with me. If you have any questions or concerns, there will be an opportunity to mention it at the end of the application form.

Please take a moment to read through the NOTICE OF PRIVACY PRACTICES AND DISCLOSURE STATEMENT.

Again, thank you for your time.