INITIAL INTAKE DOCUMENTATION:
Before completing these forms, please call 480-269-1727 to confirm that I am taking new clients. Once you have done so, please print and complete these 5 required items, then bring them with you to your first session.
Please complete and bring the above 5 forms to your initial session. Alternatively, you can fill them out with a pdf editor and forward them to me at [email protected].
Before completing these forms, please call 480-269-1727 to confirm that I am taking new clients. Once you have done so, please print and complete these 5 required items, then bring them with you to your first session.
- Client Registration and Confidential History
- Symptom Checklist
- HIPAA Notice of Privacy Practices
- Outpatient Services Contract
- Appointment Cancellation Policy
Please complete and bring the above 5 forms to your initial session. Alternatively, you can fill them out with a pdf editor and forward them to me at [email protected].
OTHER OPTIONAL FORMS:
(Required if you want your counselor to obtain or share information with other individuals/agencies) (Required if you want a family member or significant other to participate in your therapy)
The forms below may be requested sometime during your therapy. These are not required for your initial appointment.
The forms below may be requested sometime during your therapy. These are not required for your initial appointment.
We cannot avoid suffering but we can choose how to cope with it, find meaning in it, and move forward with renewed purpose.
― Viktor E. Frankl, Man's Search for Meaning