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.

Address

2101 Fox Drive,
Ste 102,
Champaign, IL 61820

Phone

217-213-3405

Contact Us!

Office Hours

Primary

Monday  

8:00 am - 8:00 pm

Tuesday  

8:00 am - 8:00 pm

Wednesday  

8:00 am - 8:00 pm

Thursday  

8:00 am - 8:00 pm

Friday  

8:00 am - 8:00 pm

Saturday  

Closed

Sunday  

Closed