Forms

**Please note, these forms do take a while to complete. Be sure to allow yourself enough time to finish so we can begin your first session at the scheduled time.

Couples: Only one of each form is required except for the Client Information Form which requires one for each partner. 

Disclosure Statement: Required before beginning therapy. Contract for therapy including rates, cancellation policy, limits to confidentiality, etc.

Client Information Form: Please print and complete one for every scheduled client. 

 

Good Faith Estimate: In concordance with the No Surprises Act, Medical Professionals are required to provide an estimate for services for all private pay individuals. This form notes estimated prices for duration of therapy. This is not a contract. 

Telehealth Consent: Please print and complete if you plan to use teletherapy services. This can be signed in addition to the In-Person Consent Form

 

In-Person Services Consent: Please print and complete if you plan to come in office for services. This can be signed in addition to the Teletherapy Consent Form.