Adult Counseling Intake Form

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Disclosure Form updated Dec 2021

included in the Disclosure Form are: COVID Precautions Agreement Form for in-person appointments and a Teletherapy Consent Form for virtual appointments.

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Notice of Privacy Practices

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Credit Card Authorization Form

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Client Information Change Form

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Release of Information Form

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EMDR Therapy Consent

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No Surprises Act Disclosure

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*If you have a kid or teen in need of services, please contact me to discuss the situation and for appropriate forms.