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Woman Being Free

New Client Information Forms

If you are a new client, please complete the following forms for each participating adult and bring them with you to your first session.

  • Counseling Intake Form - New Client
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like for us to coordinate care with another provider (for example, your primary care physician, etc.), complete this form to authorize communication and release of information with your provider:

  • Authorization to Disclose Information Form (optional)

 

Counseling Intake Form - New Client  
Limits of Confidentiality/Therapy Cancellation Policy  
Authorization to Disclose Information Form  

 

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Helpful Forms

Click here to view and print forms for your appointment.

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