Intake Form
This is a standard intake form. It will ask for your demographics, and a few questions about the concern(s) that are bringing you to see a counselor.
| Intake Form |
Informed Consent
This is a thorough consent document. It outlines policies and procedures, my privacy practices, and the potential risks and benefits of counseling. Please read it carefully!
| informed_consent_lfc.pdf |
Notice of Privacy Policies
The HIPAA Privacy Rule requires health plans and covered health care providers to develop and distribute a notice that provides a clear, user friendly explanation of individuals rights with respect to their personal health information and the privacy practices of health plans and health care providers.
| notice_of_privacy_policies_-_hipaa.pdf |
Credit/Debit Card Authorization Form
| cc_authorization_form_recurring_lfc.pdf |
Handouts & Worksheets
| What is Psychotherapy? |
| Goal Setting Worksheet |
Note: To download Adobe Acrobat Reader for free, Click Here.
