New Patient Documents

CLIENT FORMS

If you are a new client, please complete the appropriate following forms and bring them with you to your first session.

▪ALL new clients must read and sign the Policies and Procedures:

Policies and Procedures

▪Please complete the appropriate new client packet for the type of service you are receiving:

Adult Client Information
Minor Client Information
Couples Information
Family Information

▪If you are participating in Eye Movement Desensitization and Reprocessing (EMDR) Therapy, please read and sign the following form:

EMDR Informed Consent

▪If you are participating in Telehealth (Virtual Therapy), please read and sign the following form:

Telehealth Informed Consent

▪If you would like me to coordinate care with another provider (your psychiatrist, primary care physician, etc.), please complete the following form to authorize release of your information. The completed form authorizes Cambron Counseling to release protected information from your clinical record to the person you designate.

Authorization for Release of Information

Notice of Cambron Counseling Privacy Practices (HIPPA) will be provided for you at your first appointment.