Degrees:

Doctorate of Clinical Psychology
Walden University, Minnesota, Minneapolis
Completed Clinical Psychology courses and 500 hour practicum and
1500 hour internship.

Master’s Degree in Organizational Management
University of Phoenix, Denver, Colorado

Courses: Introductory Course - Foundations in Hypnosis
Hypnosis Motivation Institute, Tarzana, California

18 Advanced Courses in Hypnotherapy
Hypnosis Motivation Institute, Tarzana, California

Certification: ADD/ADHD Hypnosis
Completed a certification class
Hypnosis Motivation Institute, Tarzana, California

The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Division of Professions and Occupations. The Board of Registered Psychotherapy Examiners can be reached at 1560 Broadway, Suite 1350, Denver, Colorado 80202, (303) 894-7800.

As to the regulatory requirements applicable to mental health professionals:

 Registered psychotherapist is a psychotherapist listed in the State's database and is authorized by law to practice psychotherapy in Colorado but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain a registration from the state.
 Certified Addiction Counselor I (CAC I) must be a high school graduate, complete required training hours and 1,000 hours of supervised experience.
 Certified Addiction Counselor II (CAC II) must complete additional required training hours and 2,000 hours of supervised experience.
 Certified Addiction Counselor III (CAC III) must have a bachelor’s degree in behavioral health, complete additional required training hours and 2,000 hours of supervised experience.
 Licensed Addiction Counselor must have a clinical master’s degree and meet the CAC III requirements.
 Licensed Social Worker must hold a master’s degree in social work.
 Psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure.
 Licensed Clinical Social Worker, a Licensed Marriage and Family Therapist, and a Licensed Professional Counselor must hold a master’s degree in their profession and have two years of post-masters supervision.
 A Licensed Psychologist must hold a doctorate degree in psychology and have one year of post-doctoral supervision.

You are entitled to receive information from your therapist about the methods of therapy, the techniques used, the duration of your therapy (if known), and the fee structure. You can seek a second opinion from another therapist or terminate therapy at any time.

In a professional relationship, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies the licensee, registrant or certificate holder.

Generally speaking, the information provided by and to the client during therapy sessions is legally confidential and cannot be released without the client’s consent. There are exceptions to this confidentiality, some of which are listed in § 12-43-218 C.R.S., as well as other exceptions in Colorado and Federal law. For example, mental health professionals are required to report suspected child abuse to authorities. If a legal exception arises during therapy, if feasible, you will be informed accordingly. The Mental Health Practice Act (§ 12-43-101, C.R.S., et seq.) is available at: www.dora.colorado.gov/professions/registeredpsychotherapists.

Additionally, in the event you need to cancel your scheduled session, please be sure to contact me within 24 hours of your scheduled appointment to avoid being charged for the session. 

I have read the preceding information, it has also been provided verbally, and I understand my rights as a client or as the client’s responsible party.


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Print Client’s name




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Client’s or Responsible Party’s Signature Date Date




If signed by Responsible Party, please state relationship to client and authority to consent:

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