If you are a new client, you will need to fill out all applicable forms in the following category before your first appointment. Please call us at (360) 281-6824 if you have any questions while reviewing your new client paperwork.

Children over the age of 13 are permitted to sign for themselves in accordance with Washington state law.

 

Individual Adults

  1. Please fill out this New Client Paperwork.
  2. Please also fill out this Release of Information if there is anybody you would like your therapist to have permission to speak to (examples: a past therapist, your medication prescriber, a partner that you want to be able to schedule appointments on your behalf, etc.).
  3. If planning to use insurance, please Upload Insurance Card here, with a picture of the front and the back of the card so we can verify your insurance before your appointment.

 

 

Couples Counseling Clients: Please have each partner fill out the below form.

  1. Couples Client Paperwork
  2. If planning to use insurance, please Upload Insurance Card here, with a picture of the front and the back of the card so we can verify your insurance before your appointment.

 

Clients Age 13-18 Years Old

  1. This New Client Paperwork for Adolescents is for the client to fill out and sign.
  2. This New Client Paperwork is to be filled out by whoever will be financially responsible for this client’s appointments (often a parent/guardian).
  3. Please also fill out this Release of Information if there is anybody you would like your therapist to have permission to speak to (examples: a parent for payment and scheduling of sessions, a past therapist, your medication prescriber, etc.).  The clinic cannot communicate with a parent if this release of information has not been filled out by the client.
  4. If planning to use insurance, please Upload Insurance Card here, with a picture of the front and the back of the card so we can verify your insurance before your appointment.

 

Clients Age 12 and Under

  1. This New Client Paperwork for Children should be filled by the client’s parent/legal guardian. If there are two legal guardians, both need to sign on the same form.
  2. Please also fill out this Release of Information if there is anybody you would like your therapist to have permission to speak to (examples: a past therapist, your medication prescriber, etc.).
  3. If planning to use insurance, please Upload Insurance Card here, with a picture of the front and the back of the card so we can verify your insurance before your appointment.

 

Individual New Client Forms: If the clinic has requested you to fill out any additional forms, please fill out the requested form here.

  1. Review of Disclosure Statement 
  2. New Client Information
  3. Appointment Policy
  4. Financial Policy
  5. Authorization for Primary Care Physician
  6. Insurance ROI
  7. Upload Insurance Card
  8. General ROI
  9. Authorization for Reminder Services
  10. Therapy Agreement between Parents/Guardians of Minors and the Therapist
  11. Therapy Agreement for Minors of Divorced/Separated Parents