Intake Packet Forms

I know that the list of forms below looks like a lot.  I want you to know that careful thought was put into each and every document to only include, in the case of the policy paperwork, the information that I am required to provide you by law and that explains the policies that my practice follows.  The clinical paperwork is all designed to help me get to know you better and focus our conversation in the first session on the items that are most important to you.  You are welcome to complete these forms ahead of time or to arrive 15-20 minutes early and work on them before our session.

 Please let me know if you have any questions at all.  

To learn about different ways to return the completed forms to me in a secure/private manner…
Go to: 
Returning Completed Forms
NOTE: Regular e-mail is not secure and I cannot guarantee your privacy on it’s internet travels between you pushing “send” and it arriving in my inbox.  Once it is in my possession, I will keep it private from that point forward.

Crisis Resources

  • Crisis Resources (What to do if you are having an emergency when you are my client)

Welcome Letter

Policy Paperwork

Clinical Paperwork

  • Client Information Sheet (either print and complete OR save completed version and send file to me)
  • Background Screening   (Print and complete one of the two below.)
  • Developmental Screening (print and complete if client is under 18)
  • Self-Report   (print and complete one of the two below, unless client is under 12)