Counseling for Depression, Stress, Relationship Struggles, Anger & Self-Esteem

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Forms
~ NEW CLIENT FORMS ~

If you are a new client who has scheduled your first appointment, please complete the following forms and bring them to your scheduled visit.  Filling these out in advance of your first visit will minimize the time you spend in the waiting room filling them out when you get here.

 

Click on the forms you would like to download:

 

 
NOTICE OF PRIVACY PRACTICES
 
NEW CLIENT PACKET
1.   NEW CLIENT PAPERWORK  (INDIVIDUAL, COUPLES, & FAMILIES)                                                          
2.  HIPPA:  NOTICE OF PRIVACY PRACTICES
3.  INTAKE ASSESSMENTS ADOLESCENT 11-18
4.  INTAKE ASSESSMENTS ADULT
5.  INTAKE ASSESSMENTS FAMILY
6.  INTAKE ASSESSMENTS COUPLES
7.  PERSONAL HISTORY - ADULT
8.  CREDIT CARD AUTHORIZATION
 9.  CONCERNED PERSON REFERRAL FORM