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Therapy for IndividualsCouples, & Families
Couple Therapy Session

Intake Forms

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

906 Sycamore Ave.
S
uite 100
Vista, Ca. 92081

Phone: 760-580-7708 
Fax: 760-941-6668



Client Psychotherapy Intake Form

 

Fees & Length of Therapy

 

Limits of Confidentiality/Therapy Cancellation Policy

 

Informed Adult Consent

 

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:

 

Authorization to Disclose Information Form

 

HIPPA Notification Release

 


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