Please print and fill out each form and bring to your first appointment.

 Intake Form

 Release Form

 Responsibilities of Provider

 Consent to Treatment

Get In Touch

Contact me to see if I may be a good fit.

    If this is a medical emergency, please call 911.

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    My Office

    267 Willimantic Rd. Suite 5
    Chaplin, CT 06235
    (860) 391-7263