Intake Forms
Intake Forms
Choose 1 appropriate Intake form:
| Adobe PDF | Microsoft Word Document |
| Intake Adolescent | Intake Adolescent |
| Intake Child | Intake Child |
| Intake Adult | Intake Adult |
Review these:
Sorry for there being so much. This is the way the legal world is moving...and I must go with the flow...
| Adobe PDF | Microsoft Word Document |
| Informed Consent | Informed Consent |
| Consent for Text & Email | Consent for Text & Email |
| Notice of Privacy Practices | Notice of Privacy Practices |
If indicated complete Informed Consent for Family Therapy which addresses family confidentiality issues:
| Adobe PDF | Microsoft Word Document |
| Family Therapy Consent | Family Therapy Consent |
Instructions:
- Click on a form to download. Choose either pdf or Microsoft Word format. The Word documents are fillable. If needed, you may download Adobe Reader to read the pdf
- You must have Microsoft word, or an equivalent to read and edit the Word documents.
- Bring completed forms to your appointment.
- If you prefer to submit a form electronically, you may do so. Please email me and I will reply to you with a form which allows you to do so privately and securely.