Licensed Marriage and Family Therapist
Therapy for Individuals, Adolescents, Children, Couples, & Families

Forms

If you're a new client, please complete the forms that fit your reason for seeking therapy and bring them with you 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 the appropriate form to authorize release of psychotherapy information:

Additional Forms

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

Contact Me

Location

3300 Douglas Blvd Suite 240 Roseville, CA, 95661

Hours

916-241-3365

Monday, Tuesday, Friday, Sunday:

Closed

Wednesday, Thursday:

11:00 am - 7:00 pm

Last available appointment at 7pm

Saturday:

11:00 am - 2:00 pm

Last available appointment at 2pm