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Pursuant to the Federal Trade Commission's Red Flags Rule, we must request a copy of your insurance card (if applicable) and a copy of a government issued photo ID (such as your driver’s license). Please bring these items to your first session.

New client paperwork for adults (please print and complete):
Client Self Report Form
Counseling & Fee Policy
Consent Form
Privacy Notice

New client paperwork for children and adolescents (please print and complete):
Developmental Questionnaire
Counseling & Fee Policy
Consent Form
Privacy Notice

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If you would like these forms mailed to you, please contact us at 717-560-9969.