Paperwork

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

New Individual Client (18yrs +):
- Disclosure Agreement
- Individual Client Psychotherapy Intake Form
- Limits of Confidentiality
- Cancellation Policy

New Individual Client (under 18yrs):
- Disclosure Agreement
- Intake of a Minor Form
- Parent/Garden Consent of a Minor
- Limits of Confidentiality
- Cancellation Policy

Family Therapy: (This includes couples therapy)
- Disclosure Agreement
- Family Psychotherapy Incake Form
- Parent/Garden Consent of a Minor (if it applies)
- Limits of Confidentiality
- Cancellation Policy

Group Therapy:
- Disclosure Agreement
- Group Confidentiality Contract
- Individual Client or Family Psychotherapy intake Form
(choose the best one that applies)
- Limits of Confidentiality
- Cancellation Policy

Click on the following to download form:

• Disclosure Agreement
• Individual Client Psychotherapy Intake Form
• Family Psychotherapy Intake Form
• Intake of a Minor From
• Parent/Garden Consent of a Minor
• Limits of Confidentiality
• Cancellation Policy
• Group Confidentiality Contract

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

Your Feedback is valued: Earn a discount by filling out and returning this form to robertcrousetherapy.com.

• Feedback Form

Note: To download Adobe Acrobat Reader for free, click here .