Lyra Health Forms   

Welcome to my practice!


Prior to your first visit, please review my privacy of information policies. Please also download, complete and sign the forms below and bring them to your first appointment. If you are not able to download the forms, plan to arrive 20mn early to complete the intake paperwork.


  • Lyra informed consent for evaluation and treatment

  • Personal history (adult version)


Adolescents (12-17)

  • Lyra informed consent for evaluation and treatment (signed by legal guardians and teens age 14 and above on separate documents)

  • Personal history (adolescent version)

Client Feedback

To monitor your progress and inform your treatment, I will work with Lyra to collect your feedback on our sessions. Lyra will send you an email on my behalf that will contain information about Lyra’s services, including our sessions. You will also be invited to complete a brief questionnaire that asks about your symptoms and functioning. It’s designed to take about 5 minutes to complete. Lyra and I will periodically ask you questions about progress towards your goals. For more information, please read the PDF called "Lyra_Understanding Outcomes".