If you are a new client, please complete the appropriate Online Intake Form below.  If you are unable to access or complete the online form, feel free to print and complete the downloadable version.  In addition, printed copies of the forms are available in the office waiting areas.  Please arrive 15 minutes prior to your intake appointment time should you need to complete forms in the office

ONLINE FORMS

• Adult Psychotherapy Intake Form
  
   

• Child (ages 4-17) Psychotherapy Intake Form
  
   

• Formulario de admisión Adultos
  
   

• Formulario de admisión de niños
  
   

• Release of Confidential Information (English) (please completed downloadable version)
  
   

• Release of Confidential Information (Spanish (please completed downloadable version)
  
   

• Credit Card on File Authorization Form
  
   

• School Services - Child Minor Intake Form
  
   

• Financial Agreement and Privacy Disclosure

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DOWNLOADABLE FORMS

• Adult Psychotherapy Intake Form
  
   

• Child (ages 4-17) Psychotherapy Intake Form
  
   

• Formulario de admisión de niños
  
   

• Consent to Share Information with School (ROI)
  
   

• Release of Confidential Information (English)
  
   

• Release of Confidential Information (Spanish
  
   

• Credit Card on File Authorization Form
  
   

• School Services - Child Minor Intake Form
  
  
  
  Note: To download Adobe Acrobat Reader for free, click here.