New Patient Intake Form
Please fill out this form and provide me with some details about your current health and goals of treatment.
*Please note, filling out this form does not establish a doctor-patient relationship.
Accepted Insurance
I am currently in network with Aetna, First Choice, Moda, Pacific Source. Providence, and Regence Blue Cross/Blue Shield.
Availability
Please keep in mind this is a small, part-time private practice, open to a limited number of clients. As such, clients who may require frequent contact and urgent response may be better served by a larger practice. I am not available on a daily basis due to other commitments but will make every attempt to return calls within two business days. If a matter is non-urgent, please wait until our next appointment to discuss it.
Emergency Services
Please be aware that as a single practitioner, I am not able to provide emergency services.
If you are having a psychiatric emergency, please call 911, the National Suicide Prevention Line (800) 273-TALK, the Multnomah County Crisis Line (503) 988-4888, or go to your nearest emergency room.
