New Client Forms
*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.*
These forms are not related to our Domestic Violence program. If you are needing an assessment please contact the office.
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.
Individual Adults:
- Please fill out these New Client Forms.
- 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.).
- 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.
- If you are planning on seeing one of our clinicians in person, please attach a clear copy/photo of your vaccination card and sign this waiver: Upload Vaccination Card, In-Person Waiver
Couples Counseling:
Couples Counseling: Please have each partner fill out the below forms.
- New Couples Client Forms
- 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.
- If you are planning on seeing one of our clinicians in person, please attach a clear copy/photo of your vaccination card and sign this waiver: Upload Vaccination Card, In-Person Waiver
Adolescents Age 13-17 Years Old:
Children over the age of 13 are required to sign for themselves in accordance with Washington state law.
- This New Client Forms for Adolescents is for the client to fill out and sign.
- Please also fill out this Release of Information if there is anybody you would like your therapist to have permission to speak to (i.e., a past therapist, your medication prescriber, parent/guardian, etc.).
- This form will be filled out by the financially responsible party of the adolescent’s treatment.
- Please fill out the Therapy Agreement between Parents/Guardians of Minors and the Therapist
- Please also fill out this form if it applies to you, Therapy Agreement for Minors of Divorced/Separated Parents
- 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.
- If you are planning on seeing one of our clinicians in person, please attach a clear copy/photo of your vaccination card and sign this waiver: Upload Vaccination Card, In-Person Waiver
Children Age 12 and Under:
- 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.
- 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.).
- 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.
- Please fill out the Therapy Agreement between Parents/Guardians of Minors and the Therapist.
- Please also fill out this form if it applies to you, Therapy Agreement for Minors of Divorced/Separated Parents.
- If you are planning on seeing one of our clinicians in person, please attach a clear copy/photo of your vaccination card and sign this waiver: Upload Vaccination Card, appointment.
Additional New Client Forms:
If the clinic has requested you to fill out any additional forms, please fill out the requested form here.