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
File Size:	187 kb
File Type:	pdf

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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
File Size:	320 kb
File Type:	pdf

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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
File Size:	303 kb
File Type:	pdf

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Credit/Debit Card Authorization Form

cc_authorization_form_recurring_lfc.pdf
File Size:	208 kb
File Type:	pdf

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Handouts & Worksheets

What is Psychotherapy?
File Size:	85 kb
File Type:	pdf

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Goal Setting Worksheet
File Size:	89 kb
File Type:	pdf

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