If you are a new client, follow the directions on the informational email sent to you by our intake staff.* Complete each of the following links under the appropriate service for which you are seeking and appointment. These forms are in addition to and separate from registering on our electronic health records system, Therapy Appointment.
Please sign and return them electronically at least 48 hours before your first session. **If forms are not returned, we may have to reschedule the first appointment, as our therapists need time to review in order to best serve you. **
*If you have contacted us and have not received an email within 72 hours, please check your junk/spam folder.
ADULT INTAKE:
COUPLES INTAKE FORMS:
ADOLESCENT (12-17 years) INTAKE FORMS - please complete each link:
Adolescent Intake Parent/Guardian Form
Adolescent Checklist of Concerns
CHILD (Under 12 years) INTAKE FORMS -please complete each link:
CLINICAL SUPERVISION INTAKE
Clinical Supervision Intake Packet
OTHER FORMS - as necessary:
Child Under 14 Consent to Treatment
Special Confidentiality Notice for Parents of Children over 14 yrs
If you would like your therapist to coordinate care with another provider (for example, your psychiatrist, referral source, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here.
