Informed Consent Agreement for Minors:
Please complete the form for the therapist you are scheduled to see!
Please complete the form for the therapist you are scheduled to see!

Ingrid Higgins, LMFT | |
File Size: | 194 kb |
File Type: |

Stephanie Chase, MFT | |
File Size: | 194 kb |
File Type: |

Runjhun Pandit, APCC | |
File Size: | 196 kb |
File Type: |

Tandra Childress, AMFT | |
File Size: | 197 kb |
File Type: |

Nelson Saez, ACSW | |
File Size: | 194 kb |
File Type: |
Informed Consent for Adults:

Ingrid Higgins, LMFT | |
File Size: | 162 kb |
File Type: |

Stephanie Chase, MFT | |
File Size: | 88 kb |
File Type: | docx |

Runjhun Pandit, APCC | |
File Size: | 163 kb |
File Type: |

Tandra Childress, AMFT | |
File Size: | 164 kb |
File Type: |

Nelson Saez, ACSW | |
File Size: | 162 kb |
File Type: |
Intake Form:

Intake Form Adult | |
File Size: | 91 kb |
File Type: |

Intake Form Child | |
File Size: | 95 kb |
File Type: |
Release of information:

Authorization to Exchange Information | |
File Size: | 312 kb |
File Type: |
Credit Card Authorization:
Have a teen who will be driving themself to therapy? We can keep a card on file, so they don't have to remember to bring payment anytime! If you choose to do this, please complete the form and email or fax it to your therapist.
Have a teen who will be driving themself to therapy? We can keep a card on file, so they don't have to remember to bring payment anytime! If you choose to do this, please complete the form and email or fax it to your therapist.

Credit Card Authorization | |
File Size: | 156 kb |
File Type: |