Client Counseling Forms
Client Counseling Forms
All forms on this page are HIPAA-secure.
Use this form to start the therapy process.
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.
Placeholder
Placeholder
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