If you are a new client, please complete the following forms and bring them to your first therapy session.
- Form 00 Counseling Information
- Form 01 Consent For Treatment
- Form 02 Client Information
- Form 03 Agreement to Pay
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
If you are planning to use insurance to pay for therapy, then please contact Amanada Love at (508) 801-3419 prior to our meeting to learn about your insurance coverage and copay/co-insurance amount, which is due at the time service is delievered.
- Note: To download Adobe Acrobat Reader for free, click here.