Intake Forms

The initial session in which someone begins counseling is called the intake session. During this session I will gather basic background and contact information, explain privacy and confidentiality and their limits, walk you through the legal aspect of therapy, and begin talking about what is bringing you into counseling.

In order to streamline this process please download, read through, and fill out the following forms and bring them in to your intake session. Also, feel free to think about any questions you may have about me as a counselor or the counseling process that you would like to ask me during our first session.

General Forms:

HIPPA Privacy Practices

Insurance Information

Professional Disclosure Statement

Release of Information

Adult Forms:

Adult Background History Form

Couples Intake Form

Child and Adolescent Forms:

Child & Adolescent Background History Form

Parental Consent to Treat Form

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