Client Forms and Resources PageComplete intake onlineStep 1: Do you have an appointment already, you can complete your intake assessment online!Step 2: registration & disclosure complete and sign Intake forms to print
Child Intake Form Credit Card Authorization Form Release of Information-
your mental health notes and file is protected by law, if you would
like to have your information released to anyone you must complete the
form above. I cannot acknowledge or deny that you receive mental health
services with me. Please read carefully my disclosure and HIPPA
guidelines to understand about your privacy. Educational Resources
Mental health related video links | 425-444-5902 submit a appointment request online  RENTON OFFICE: 321 Burnett Ave South Suite 300 Renton, WA 98055 -Request an appointment BELLEVUE OFFICE: 1621 114th Av SE Ste 224 Bellevue,WA 98004 - Request an appointment |
