Please note that filling out a new client form does not automatically schedule you with that practitioner. If you would like to schedule an initial appointment please call us at (360) 281-6824.

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 these New Client Forms.
  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: Please have each partner fill out the below forms.

  1. New Couples Client Forms
  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.

 

Adolescents Age 13-17 Years Old

  1. This New Client Forms for Adolescents is for the client to fill out and sign.
  2. This form will be filled out for the financially responsible party of the adolescent’s treatment.
  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 past therapist, your medication prescriber, etc.).
  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.

 

Children Age 12 and Under

  1. These New Client Forms 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.

 

 

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

  1. Insurance ROI
  2. Upload Insurance Card
  3. Therapy Agreement between Parents/Guardians of Minors and the Therapist
  4. Therapy Agreement for Minors of Divorced/Separated Parents
  5. Visitors to Treatment
  6. Clinician Disclosure Statement