If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session. You may also scan the document once you have filled it out and email it to me at Lynda@phillipscounselingpc.com.
Please print and fill out forms 1, 2, 3, 4 and 5. Return them to me, either by email or bring them to your first session.
Lynda@phillipscounselingpc.com
Lynda@phillipscounselingpc.com
- Informed-consent-and-office-policy
- Technology Consent
- HIPPA Notice of Privavcy Practices
- Assignment of Insurance Benefits and Billing Authorization Form
- Client Contact and Intake Form-Adult
- Client Contact and Intake Form-Minors
- Authorization to Release Information
- Out Door Consent
- Email and Texting Risk Ques
- Transmission of Protected Health Information
