Forms and Policies for Adult Patients (18 and older)
New patients, please print and complete all forms and bring them with you to the first meeting.
Intake Form for Adults:
Basic personal information filled out by clients 18 years of age and older.
This document includes a "welcome to my practice," a discussion about fees and insurance options, risks and benefits, confidentiality, record keeping, patient rights, and policies when treating minors.
New Hampshire Privacy Notice
This document describes how information about you may be used and disclosed, client protections, and how you can get access to this information.
Mental Health Bill of Rights:
In New Hampshire, it is required by law that everyone engaged in mental health treatment receive this document describing a client's fundamental rights.
Consent to Treatment:
This document is a contract to work together and states that you have read the above two documents, had your questions answered, and that you intend to proceed. This is required before engaging in counseling.