If you are the parent/guardian of a teen who is coming in to see me for the first time


Please click on the blue link below to print and complete the forms in the intake packet. Have your teen bring all completed (signed by the parent/guardian) pages to their first appointment.


*Make sure to fully read the two documents below (in green) before signing the two signature pages in the intake packet. If you have any questions, feel free to contact me.

All clients: Please carefully read the documents in green (below) 

and contact me with any questions. These documents are for your reference only, I do not need copies of them. 

​​​Teens

​Amy Gray, LICSW - 70 Main Street, 2nd Floor

 Northampton, MA 01060 - 413-522-4903 - amyg.49@verizon.net

​​Forms

Release of information form for adults:

If you would like me to coordinate care with another provider (for example, your psychiatrist, physician, etc.), complete the release of information form (below) and bring a hard copy to your appointment. 

​​​​​Adults

Release of information form for teens:

If you would like me to coordinate care with another provider (for example, your child's school, psychiatrist, pediatrician, etc.), complete the release of information form (below) and bring a hard copy to your child's appointment.

​​​​​​If you are a new psychotherapy client: 


Please click on the blue link below to print and complete the forms in the intake packet. Bring all completed pages to your first appointment.


*Make sure to fully read the two documents below (in green) before signing the two signature pages in the intake packet. If you have any questions, feel free to contact me.