Please Read!
To minimize the time and wait prior to sessions at our office, please fill out the applicable form below. You may submit it to us prior to your appointment via email to [email protected]. Alternately, you are welcome to bring it with you prior to your scheduled appointment. Thank you for your understanding and we look forward to serving you!
Addiction, Individual, or Group Therapy
Intake Form
Please download AND print both of these documents prior to your appointment. If a printer is not available, these can be provided before your session. Allow 30-40 minutes to complete these if in person.
This form includes:
- General Health Information (Including Family History)
- Treatment History (if Applicable)
- Personal Background
- Relationship and Living Situation
To download the form, CLICK HERE. Adobe Acrobat Required to view PDF.
Leadership and Professional Services
Intake Form
Please download AND print this document prior to your appointment with a Leadership Coach. If a printer is not available, these can be provided before your session. Allow 10-15 minutes to complete these if in person.
This form includes:
- Professional Background Summary
- Leadership Questionnaire
- Informed Consent Policy
- Medical Emergency Release
- Informed Consent for Electronic Messaging
- Notice of Privacy Practices
- Financial Agreement
To download the form, CLICK HERE. Adobe Acrobat Required to view PDF.
Intake Client Policy
This document includes:
- Informed Consent
- Medical Emergency Release
- Professional Disclosure
- Privacy Practices
- Health Advisement
- Financial Agreement
- And More…
To download the form, CLICK HERE. Adobe Acrobat Required to view PDF.
Intake Client Policy
This document includes:
- Informed Consent
- Medical Emergency Release
- Professional Disclosure
- Privacy Practices
- Health Advisement
- Financial Agreement
- And More…
To download the form, CLICK HERE. Adobe Acrobat Required to view PDF.