These are our fliers and forms (in PDF format); you will need Adobe Reader to read and print them.
You can complete these yourself and bring them with you when you first visit our offices.
- Consent Form
- HIPAA Release Form: This form describes the confidentiality of your medical records, how the information is used, your rights, and how you may obtain this information.
- Client Intake Form: General information, symptom checklist, etc.
- Financial/Billing Practices: Our policies about payments, insurance, cancellations, and related matters concerning client’s financial responsibilities.
- Release of Information Form: Only needed if you want to allow MFT3 to speak with a physician, attorney, teacher, or anyone else concerning your case.
For your convenience, we’ve also assembled all of these forms into a complete package: download it here.
- Balance Wheel: An short exercise about aspects of partnership, intimacy, and connection in your life