If you’re a first-time client, please review and complete the following forms, bring them to your first session. Each client should read, complete and sign a set of the forms posted below.
Parental consent for treatment of minors requires to signature of both parents.
- Client Intake Form 2014 copy 2
- Informed Consent Adults 2014 1 copy 3 - Informed Consent
- Notice of Privacy Policy (Print if desired)
- Acknowledgement of Receipt of Privacy Policy
- Therapy Partners Electronic Authorization Form
If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:
Note: These forms are in Word and PDF format. To access PDFs and download Adobe Acrobat Reader for free, click here.
Thank You,
Lisa Maurel, MFT