Client Forms

If you’re a new client, please complete the following forms and bring them to your first therapy session.

Intake Paperwork

Anxiety Screening

Substance Abuse Assessment

Depression Screening

Credit Card Authorization Form

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:

Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, click here.

 

Contact Today


Concord on the Creek
6750 Hillcrest Plaza Dr.
Suite 304
Dallas, TX 75230

wholeselftherapydallas@gmail.com
972-591-3761

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