New Client Forms Checklist

Please have all necessary forms completed and submitted prior to our first session. Thank you.

□ 1. Intake Form

□ 2. Teletherapy Agreement

□ 3. Teletherapy Informed Consent

□ 4. Missed Session/Cancellation Policy

□  5. Couples Therapy Intake Form (if applicable)

 

Additional For Medicare Clients:

□ 6. Assignment of Medicare Benefits

□ 7. Front and Back Photos of Medicare Card and Supplement Card