Welcome to the Online Intake. Please be sure to review the information in the Notice of Privacy Practices, Electronic Communications, and Contract for Services. This information is important, as it relates to your rights and responsibilities while you are an active client with me. Our professional relationship will focus on helping you with very personal matters, and I want for you to be fully informed of the parameters of this relationship. Please contact me (512-789-6754) with any questions or concerns about the intake forms.

  1. Please complete all required sections.
  2. Clients who would like to use health insurance, please complete the Insurance Information section, as well.
  3. Clients who are experiencing symptoms of anxiety or depression should also complete the corresponding Beck Inventory. For relationship problems, complete the RDAS. For substance use problems, complete the CAGE-AID.

Required Sections