Please print out both the Intake Form and the Treatment Ageement.

Fill them out and bring it to your first appointment.


During Shelter in Place you can mail these forms to Dr. Zechowy's office:

725 College Avenue
Santa Rosa, CA 95404

or you can fax them to her office at 844.255.0408.

Intake Form (4 pages, 5MB)

Treatment Agreement (1 page, 10 MB)