Helpful Forms | Sleepy Hollow, NY

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

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:

    • Authorization to Disclose Information Form

Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, click here .


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Helpful Forms

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Adrienne Resnick, LCSW-R, ACSW
914-633-3389
239 North Broadway
Suite 6
Sleepy Hollow, NEW YORK 10591

[email protected]

Now Serving the Following Areas: Sleepy Hollow, Tarrytown, Irvington, White Plains, Chappaqua, Scarsdale, Hartsdale, Armonk


Specialing in: Children's Counseling, Play Therapy, Divorce Counseling, Adolescent Group Therapy, Marriage Counseling, Couples Counseling, Family Therapy


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