Annabel Agee, PhD, LPC/MHSP, NCC
Individual, Couples, and Family Therapy
NEW CLIENT INTAKE FORMS
in WORD format
WELCOME LETTER
Informed Consent for Behavioral Health Treatment
CONSENT to Use and Disclose Protected Health Information for the Purpose of Coordinating with Insurance Carrier
AUTHORIZATION TO RELEASE INFORMATION
FINANCIAL RESPONSIBILITY AGREEMENT
CLIENT DATA
Symptom Checklist
Family Chart
SELF ASSESSMENTS I-VII