Forms

Below are forms you may choose to access now, fill out and bring with you to our office. If you’re a new client, choose the Intake Form complete it and bring it along with your insurance card or a copy of your insurance card. We also encourage you to complete and bring the Insurance Worksheet so that we can help you get all the coverage you’re entitled to and make the process go as smoothly as possible. Also if you’re a new client, please arrive 15 minutes prior to your scheduled session time to finalize all paperwork.

Adult (individual, couples and/or family counseling)

• Intake Form (English|Spanish)
• Insurance Worksheet
• Financial Policy Agreement
• Informed Consent Counseling Agreement
• HIPAA Policies (Summary|Full)
• Individual Questionnaire
• Authorization to Release and-or Exchange Information

Espanol

• Consumo
• Acuerdo de Politica Financiera
• Cuestonario Individual
• Aviso De Las Practicas De Privacidad (Resumen|Completo)
• Cuestonario Individual
• Autorizacion Para Obtener Y/O Intercambiar Informacion

Child/Adolescent Counseling

• Intake Form (English|Spanish)
• Informed Consent Counseling Agreement
• Parent/Guardian Consent for Treatment
• Insurance Worksheet
• Financial Agreement Form
• HIPAA Policies (Summary|Full)
• Adolescent Questionnaire
• Child-Adolescent Questionnaire—to be filled out by parent/guardian
• Authorization to Release and-or Exchange Information