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Forms for Intake Appointment
Please look for the type of therapy service you have been scheduled for in the intake appointment. Please download all the forms, fill them out, and print them. Bring all the listed intake forms to your intake appointment and provide them to your therapist at the beginning of your session. We also wanted to provide you with a document that will help you ask the right questions should you consider contacting your health insurer for possible reimbursement.
FAQs: FAQ

Individual Adult Therapy
(1) Intake Form (Individual)
(2) Informed Consent Agreement
(3) HIPAA Privacy Notice (for you to keep)

Individual Child/Adolescent Therapy
(under 12 years old)
(2) Informed Consent Agreement
(3) HIPAA Privacy Notice (for you to keep)

Individual Adolescent Therapy
(over 12 years old)
(3) Informed Consent Agreement
(4) HIPAA Privacy Notice (for you to keep)

Couples Therapy
(1) Intake Form (one filled out by each partner)
(2) Informed Consent Agreement
(3) HIPAA Privacy Notice (for you to keep)

Co-parenting Therapy
(1) Intake Form (one filled out by each parent)
(2) Informed Consent Agreement
(3) HIPAA Privacy Notice (for you to keep)

Parent Child Interaction Therapy
(2) Consent for PCIT Video-recording
(3) Informed Consent Agreement
(4) HIPAA Privacy Notice (for you to keep)

Psychological Assessment and Testing
(1) Parent Intake Form for Psychological Testing
(2) Informed Consent Agreement for Testing
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