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HopeLife Counseling
Woman Standing on Dock
Woman Standing on Docks

First Appointment Forms

For new appointments:

Please read and complete the following forms.  You may bring these to the first session, send via email or fax.

 

*  Intake Form (For adults - 18 years and older - who are participating in therapy)

*  Informed Consent (Please read and complete signature page.)

*  Payment Schedule (Please read and complete signature page.)

*  Insurance Form (If using insurance, please return prior to first appointment via email or fax) 

*  Minor Intake Form (Intake form for Minors - those under 18 years of age - who are participating in therapy)  

   HIPAA Notice (Please review for your understanding and personal records)

 

 

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:


* These forms are required before counseling services can be provided.

Schedule Appointment

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Helpful Forms

Click here to view and print forms for your appointment.

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