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 13-18 Years Old

  1. This New Client Forms for Adolescents is for the client to fill out and sign.
  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.

 

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. 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