Forms

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

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

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

Location

Advance Healing & Integrative Services L.L.C.

Address

9375 East Shea Boulevard,
Suite 100,
Scottsdale, AZ 85260

Advance Healing & Integrative Services L.L.C.

Address

418 North Main Street,
Suite 200 - #3877,
Royal Oak, MI 48067

Please Feel Free To Contact my Office Anytime

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Please do not submit any Protected Health Information (PHI).