David Gerard, Licensed Clinical Psychologist
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David Gerard, PhD
Licensed Clinical Psychologist

If you're a new client, please complete the following forms and bring them to your first therapy session.
Client Information Form
File Size: 344 kb
File Type: pdf
Download File

Guidelines for Clients and Consent to Treatment
File Size: 396 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 343 kb
File Type: pdf
Download File

Consent to Use and Disclose Your Health Information
File Size: 215 kb
File Type: pdf
Download File

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), please use the following form:
Authorization for Release of Information
File Size: 59 kb
File Type: pdf
Download File

Location

1115 Broadway
a/k/a 16 Madison Square West
New York, NY 10010

Telephone

(646) 355-8037

Email

[email protected]
  • Home
  • How AEDP therapy works
  • About Me
  • FAQ
  • Contact