FORMS

If you would like to become a patient, please fill out an intake form, treatment agreement, and HIPPA.

Once I get these forms from you I will contact you to schedule an intake meeting**.

** The first Intake meeting for children clients is for guardians only (without the child).

Fill out this intake form if you seek individual therapy or parent support for children under the age of 18y.

Fill out this intake form if you seek individual therapy and you are over the age of 18.

Please fill out this form weekly and send it to Dr. Arie no later than 24 hours before your meeting.

TREATMENT AGREEMENT