If you're a new client, please complete the following forms and bring them to your first therapy session.

 Limits of Confidentiality/Cancellation

 Consent for Treatment

 Patients’ Rights and Responsibilities

 Notice of Privacy Practices 

 Doctor Referral

*Consent to Release Information

 Couples Assessment

 Professional Disclosure Statement

 

*If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to   authorize release of psychotherapy information.

 

“There are no facts, only interpretations.”  Friedrich Nietzsche

© 2016  Carrie Mitchell Counseling

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