Client Counseling Forms

All forms on this page are HIPAA-secure.

Use this form to start the therapy process.

Complete this form during the intake process before you begin therapy.

Complete this form before every session.

Complete this form if you want me to speak with someone other than you about your case.

Authorization for Release of Information

Complete this form if you want me to share any or all of your records with you or a third party.

Areas of Interest Checklist

Complete this form during the intake process to help inform your treatment plan.

Learning Reflection

Complete this assessment after a learning activity to share your perception of the activity.

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Change to emergency contact information

Changes to contact information

Request for change of appointment

Records request

Request for non-secure communications

Request for non-secure records transmission