New Client Forms
Every client is required to sign and fill-out the following documents (which are included in the New Client Packet below), and bring them to the first session. These forms will be included in the confirmation email we send when scheduling the first appointment. You may preview the documents below.
- Statement of Understanding and Consent for Treatment
- Statement of Understanding and Consent for Electronic Communication
- HIPAA Notice of Privacy Practices
- Statement of Financial Responsibility (given by each clinician)
- Professional Disclosure Statement (given by each clinician)
- Confidential Client Intake Information (see below)
These optional forms are available if they apply to you. The Release of Protected Health Information form allows us to communicate and coordinate treatment with other health professionals or someone you designate. The ACH Payment form gives us permission to take payments directly from your bank and avoid additional transaction fees.
New Client Intake Packet
This is a PDF document that you will be required to complete and bring with you to the first session.
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This document will be sent to you in the confirmation email for your initial appointment. You will need to fill it out and bring it with you to the first visit.
Download PDF documentIntern Forms
Select this option to download the new client forms specific to our counseling interns; these are required for all new clients.
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Please download and print, fill out, and sign the document then bring it with you to the first session.
Download PDF Forms