Required Forms

Below are several forms that you will either need to read and sign, or fill out and sign. 

Intake Form - Please Print Out and Complete This Form

To help things go as smoothly and easily as possible when you come for your first session, we strongly recommend that you print out and complete the Intake Form and bring this with you to your first session. If you do not do this prior to coming for your session, we suggest you arrive at least 15 minutes early so you can complete this form before the session is scheduled to begin. This will help ensure that you have the maximum amount of time to spend talking with your therapist rather than doing paperwork. Please note that each adult who is participating in the therapy process needs to complete an intake form.  

Consent for Treatment Form AND Notice of Privacy Practices Form - Please Read Both Forms and Sign the Last Page of Consent Form

When you meet with your therapist for the first time, she or he will ask you to read both the Consent for Treatment and the Notice of Privacy Practices documents and to sign the last pages of the Consent for Treatment form acknowledging you have been provided with both documents. To help increase the time you will have in your first meeting with your therapist, we recommend that you print out and read both of these documents before you come for your first appointment. This way you will not have to spend any time reading during your first meeting with your therapist, and if you have any questions you can come prepared to ask these before you sign these documents with your therapist.

Child Consent for Treatment Form on their behalf.

For minors under the age of 16, parents or guardians should complete a Consent for Treatment of a Minor form. In cases of separated or divorced parents, if you have SHARED LEGAL custody, both parents must sign the child consent form. If you have SOLE LEGAL custody please provide a copay of separation or divorce orders.

Consent to Release Information Form

 

If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), print, fill out and sign, and submit to your therapist the Consent to Release Information Form that will authorize the release of psychotherapy information.


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