Planting seeds of change throughStrengthened Relationships
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Intake Forms


 

New Clients:
Please print and complete:

1. All of the following forms:

2. Please print and complete one history form:

 

 

 

 

3. Print the Services Agreement and Disclosure form for your provider:
 

4. If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information: 

 

 


Note: To download Adobe Acrobat Reader for free, click here.

Helpful Forms

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