New Client Intake Forms

All new clients should complete the following forms and bring them to your first therapy session. Child client intake forms are to be used for children under the age of 18.  The Notice of Privacy Practices  (HIPPA) form is included for your convenience, but does not have to be returned to the first session.

Selection	File type icon	File name	Description	Size	Revision	Time	User

	Intake Forms

Selection	File type icon	File name	Description	Size	Revision	Time	User
	Ċ	Onine Child-Adolescent Inake.pdf View Download		335k	v. 2	May 11, 2020, 8:37 AM	Shana Mercer
	Ċ	Online Adult Intake.pdf View Download		331k	v. 2	May 11, 2020, 8:37 AM	Shana Mercer

	Parent Facilitation

Selection	File type icon	File name	Description	Size	Revision	Time	User
	Ċ	NOPP_Acknowledgement.pdf View Download		396k	v. 7	Apr 8, 2020, 2:53 PM	Shana Mercer
	Ċ	PF_Advisement.pdf View Download		496k	v. 7	Apr 8, 2020, 2:53 PM	Shana Mercer
	Ċ	PF Data Form (1).pdf View Download		149k	v. 2	May 11, 2020, 8:34 AM	Shana Mercer
	Ċ	PF Fee schedule .pdf View Download		247k	v. 7	Apr 8, 2020, 2:54 PM	Shana Mercer
	Ċ	PF Services Into Letter .pdf View Download		165k	v. 7	Apr 8, 2020, 2:54 PM	Shana Mercer