After you click on one of the links below, you will be asked to enter your name and email address and then will be able to complete and submit the form.

Please note, if you would like us to send your records to another provider/location, please complete the relevant link below and then directly contact us at 206-374-0109 so we can initiate this process. We are available 9 AM – 5 PM, Monday-Friday.

Telehealth Consent

Release of Information (Verbal Coordination of Care, Billing, and Scheduling)

Release of Information (Release of Psychiatry Medical Records)

Release of Information (Release of Therapy Notes/Records)


Our Teen Intensive DBT Program has openings!

The DBT Adolescent and Family IOP is a comprehensive program designed for individuals experiencing emotion dysregulation and who want to make rapid progress! Call to screen today!