Intake Forms

For your first therapy, please be sure to bring your printed filled out forms. View the list of forms provided below and fill out the applicable intake form for your session. If you are coming for a couple’s therapy, be sure that both you and your spouse bring a completed Couples Counseling Assessment and Consent Form. Date all forms according to the schedule of your initial appointment.

Adult Clients:

• Adult Intake Packet
• Credit Card Form

Children and Adolescents (please download, print, and complete both forms):

• Child Intake Packet
• Statement of Understanding Child Therapy

Additional Forms for Couple Counseling (please complete both forms):

• Couple-Informed-Consent Form
• Couples Questionnaire

Coordination of Care:

• Release of Information
• Release to Primary Care Physician

Others:

• Advanced Care Plan
• Client Symptoms
• Practice Policies