If you're a new patient, please print out and complete the following form and bring it to your first therapy session.
Please note that I am not a Medicare or Medicaid provider and you will therefore not receive reimbursement from Medicare or Medicaid for my services. If reimbursement is very important for you, the best option may be to seek out a Medicare or Medicaid provider.
- Dr. Thorsheim Patient Psychotherapy or Psychological Assessment Intake Form
- Dr. Albers Patient Psychotherapy or Psychological Assessment Intake Form
If you would like Dr. Thorsheim to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
- Dr. Thorsheim Authorization to Disclose Information Form
- Dr. Albers Authorization to Disclose Information Form
Note: To download Adobe Acrobat Reader for free, click here.