Intake Forms
The following forms are available for download. You must have a PDF Reader installed on your computer. Please save them to your desktop, fill them out electronically, and then return them to me before our first session together by secure email to peacefulpathcounseling@protonmail.com.
New clients must complete and return the Intake Questionnaire, the Informed Consent for Clients, and the Notice of Privacy Practices. Please thoroughly read each form so we can review and discuss any questions or concerns you may have during our first session together.
Please also include a picture of your insurance card and photo ID, if applicable, along with your completed forms. This picture may be taken with a smartphone.
For clients requesting that information pertaining to our sessions be released and/or obtained, please complete and return the Release of information Form. It can also be filled out electronically and returned to me by secure email to peacefulpathcounseling@protonmail.com.
*Please note, the use of secure email is for existing and inquiring clients ONLY. Also, please confirm my availability, and that you have an appointment scheduled, before filling out any forms.
The following forms are available for download. You must have a PDF Reader installed on your computer. Please save them to your desktop, fill them out electronically, and then return them to me before our first session together by secure email to peacefulpathcounseling@protonmail.com.
New clients must complete and return the Intake Questionnaire, the Informed Consent for Clients, and the Notice of Privacy Practices. Please thoroughly read each form so we can review and discuss any questions or concerns you may have during our first session together.
Please also include a picture of your insurance card and photo ID, if applicable, along with your completed forms. This picture may be taken with a smartphone.
For clients requesting that information pertaining to our sessions be released and/or obtained, please complete and return the Release of information Form. It can also be filled out electronically and returned to me by secure email to peacefulpathcounseling@protonmail.com.
*Please note, the use of secure email is for existing and inquiring clients ONLY. Also, please confirm my availability, and that you have an appointment scheduled, before filling out any forms.