Forms

Please print and complete the below forms and bring to your first session. In addition, if you’re seeking couples counseling, please see below for the Couples form, to be completed by each partner.

Client Registration Form – download (pdf)

Privacy Practices (HIPAA) –  download (pdf)

Checklist of Concerns and Characteristics – Adult – download (pdf)

Observation Sessions – download (pdf)

Informed Consent Valentine Couples or Families-download(pdf)

Bill of Rights – download (pdf)

Couples Only

Couples Satisfaction Checklist – download (pdf)

Couples Questionnaire – download (pdf)