Request Appointment

If you're a new client, please complete the following forms and bring them to your first therapy session.

Patient Intake Forms

• Client Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
• Insurance Form
• Authorization to Disclose Information Form
• PCL-5
• PHQ-9
• Medication History

DUI/Substance Abuse Intake Forms

• Client Psychotherapy Intake Form
• Limits of Confidentiality/Therapy Cancellation Policy
• Authorization to Disclose Information Form
• PCL-5
• PHQ-9
• Medication History

Workers Comp Intake Forms

• Client Psychotherapy Intake Form
• Insurance Form
• Authorization to Disclose Information Form
• PCL-5
• PHQ-9
• DWC-1 Required
• Medication History

Assessments

• PCL-5
• PHQ-9
  
  

Resources

• PTSD DBQ
• CFR Evaluations
• CFR Diagnosis
• CFR Ratings
• M21-1 Evaluation
• M21-1 Service Connection

Forms in Spanish

• Fomulario De Admision
• Authorization to Disclose Information Form
  
  

Additional Forms:

• Low Income/Sliding Scale Application
• Medication History

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