Intake Forms

This form will gather basic information needed to begin counseling as well as inform you about our policies and procedures.  We ask that each new client also keep a credit card on file so that we can expedite billing services.

Covid-19 Vaccination Form

This form will need to be completed by any person who will be coming into the office for sessions.  This form is needed for our clients as well as any other family members who physically come to the office with them.  Clients who participate in counseling services using only our telehealth platform do not need to complete this form.  We will review the need for this form periodically.

New Client Assessment

This form will help your counselor understand your needs in counseling. Please complete this document and before your first session. If you are seeing a marriage therapist please have each spouse or partner complete her or his own form.

Telehealth Authorization

This form is for the purpose of informing you and asking your consent for the use of telehealth and other telecommunication formats.

Release of Information

This document allows us to communicate with others outside of our practice, such as family members, other providers, etc.

Please fill out one form for each person with whom you would like us to communicate.

PDF Forms

Please click on either form to see a PDF version of our Privacy Practices or our Consent for Treatment forms.