If you're a new client, please save the following forms to your hard drive, then open them and complete the forms. After completing them, print them out and either fax them to 817-473-4998 or email them to [email protected] .
Note:
You can print out these forms, complete and sign them and then scan and email them to [email protected]
OR
Download them to your computer and open them with Adobe Reader if you would like to fill them in and sign them for automatic submission directly to us!
- Client Psychotherapy Intake Form
- Limits of Confidentiality
- Teletherapy Agreement and Informed Consent
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Note: To download Adobe Acrobat Reader for free, click here .
Please use Adobe Acrobat Reader to fill out the forms after you download them if you would like to digitally sign the forms you download.
