Forms

There are a few forms that may need to be completed as we work together. I will attempt to keep them short and simple, but they are necessary for information gathering and documenting how you would like me to handle your Personal Health Information (PHI).

At this location there are Intake Forms for Adults and Couples and Children and Adolescents for your convenience. A document letting you know how your privacy will be protected also is included.

HIPPA - Notice of Privacy Practices

Intake Information Form for Children and Adolescents

Intake Information Form for Individuals and Couples