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Enrich your life
   through beneficial therapy

Forms to Download

If you're a new client, please complete the following forms and bring them to your first therapy session.

  1. BulletAdult Intake Form

  2. BulletChild Intake Form

  3. BulletConsent for Treatment in Texas


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:

  1. BulletAuthorization to Release Information

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Audrey Burgess, Ph.D.
Clinical Psychologist
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