Forms
|
|
Individual Counseling Session Forms
Prior to your first appointment, our 'intake packet' must be completed. Please download the packet from the link below, print documents, fill out, and bring to your scheduled appointment. If you have any questions please contact us.
PATIENT AGREEMENT & HIPPA DISCLOSURE:
Please read prior to completing the 'Intake Form'.
Please read prior to completing the 'Intake Form'.
| untangled_patient_services_agreement__hipaa_disclosure.pdf |
INTAKE FORM:
Must be completed prior to first appointment. Please print this form, fill out, and bring to your first appointment.
Must be completed prior to first appointment. Please print this form, fill out, and bring to your first appointment.
| untangled_intake_packet_without_agreement__hipaa.pdf |
Group Counseling Forms
GROUP COUNSELING CONTRACT:
Please print and fill out prior to your first group session.
GROUP COUNSELING SURVEY:
Please print and fill out prior to your LAST group session.
|
Release Forms:
RELEASE INFORMATION:
To be printed and filled out when specifically requested by your counselor.
WAIVER AND RELEASE FOR PUBLICATION:
To be printed and filled out when specifically requested by your counselor.
| ||||||||