Intake Forms

After scheduling your 1st appointment, please download the PDF intake form below that coordinates with the work you will be doing (Individual/Couples/Coaching)

Complete the document and bring them with you to your first appointment.

You will also find the HIPAA (privacy) and NSA (No Surprises Act) forms

below that you may review online or print for your own purposes.

To best utilize our time together, please have all documents printed out,

completed, read through thoroughly, and signed. 

If you have any questions, please note them and ask in your appointment or via email.  

1.) Click on the icon below to download the Individual Client Intake Form

2.) Click on the icon below to download Couples Intake Form

3.) Click on the icon below to download the HIPAA Privacy Act Form to keep for your own personal records

4.) Click on the icon below to download the
NO SURPRISES ACT Document (for our practice)
 (OMB Control Number: 0938-1401)
to keep for your own personal records.
**Your individual provider will provide you a personalized document with their rates for services at your intake appointment. Session rates are also posted on each individual counselor's information page. **

OR)  Click on the icon below to download the
Consultation/Coaching Intake Paperwork