New Client Forms

New Clients > Required Forms

New Clients > Required Forms

ROI:

Download-01Release Of Information:

This form allows Authentic Counseling to work alongside your previous and current providers in order to provide quality and collaborative therapeutic services. It is required should you want any information shared with another person or provider.

Intake Form:

Download-01Intake Form:

I am here to serve you and help you find your most authentic self. Please fill out this intake packet prior to your first appointment to help me learn more about you and areas in which you may be needing additional support and exploration. These records are confidential and will remain so even after sessions end.

Credit Card Form:

Download-01Credit Card Form:

This form allows for you to keep your credit card information on file so that you can pay after your session and you are already on your way. This is also a way for you to pay for missed/cancelled appointments that may fall within 24 hours of your appointment.

Limits of Confidentiality:

Download-01Limits of Confidentiality:

You privacy and confidentiality is of the up most importance, however there may be certain circumstances in which your confidentiality maybe broken. Within this document each of those circumstances are explained in detail to keep you better informed.

Professional Disclosure:

Download-01Professional Disclosure:

I believe that power is knowledge and by reading and filling out this form you can better understand the guidelines for therapists in the state of Colorado and know where and how to voice concerns should any arise in sessions.

Minor (under 18) Intake Forms

Minor (under 18) Intake Forms

Consent to Teat a Minor

Download-01Consent to Teat a Minor

This form is required for any patient under 18 years of age.

Parent or Guardian Confidentiality Agreement

Download-01

Parent or Guardian Confidentiality Agreement

I understand that as a parent you want to know that your child is making progress. I am also sure that you can appreciate that not everything your teen talks about in session is something they will want to be shared outside of sessions. This form talks about the various topics that can be discussed in sessions and the process of disclosure with guardians.