FORMS AND DOCUMENTS
If you're a new client, please complete the following forms and bring them to your first therapy session.
- Client Psychotherapy Intake Form
- Limits of Confidentiality/Therapy Cancellation Policy
- informed-consent.pdf
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.

PLEASE FEEL FREE TO CONTACT ME!
Please do not submit any Protected Health Information (PHI).
ATLANTIC COUNSELING AND EDUCATIONAL SERVICES
sunday:
8:00 AM - 4:00 PM
monday:
9:00 AM - 9:00 PM
tuesday:
9:00 AM - 9:00 PM
wednesday:
9:00 AM - 9:00 PM
thursday:
9:00 AM - 9:00 PM
friday:
9:00 AM - 9:00 PM
saturday:
8:00 AM - 4:00 PM
Address:
3010 Highland Parkway suite 200, Downers Grove, IL 60515, USA
Phone Number:
(609) 273-1641