Client Forms
Below are forms we use to collect information to serve our clients most effectively. We value your privacy. Questions? Need assistance? Please contact us.
New Client Intake Form
You can fill out the form digitally or download a hard copy.
HIPPA (Patient Privacy) Policy
Authorization Form
Would you like us to release information to a designated person? You can specify this here. Please download and sign the form, then return it to us. Thank you.
Payment Contract
Please download the form, sign it and return it to us. Thank you.
For Third-Party Payments
Sometimes someone other than the client chooses to pay for counseling. If you are that person, please fill out this form, sign it and return it to us. Thank you!
Telehealth Consent
This form gives us your permission for a telehealth session. Please download it, sign it and return it to us. Thank you.
Parent Agreement
This agreement is for separated or divorced parents whose children are receiving counseling. Please download the form, sign it and return it to us. Thank you.