Adult
If you are an adult client, please download, complete, and bring to your first appointment the following Form, which will save you about 20 minutes at the office:
Click Here to download and complete the adult form
Also, read the HIPAA and Therapy Agreement/Policies/Consent Forms. These are available for download if you wish to store or print them for yourself. You will be asked to initial and sign a form in my office that you agree with the information in each of these forms.
Child/Adolescent
If you are bringing a child/adolescent client for counseling, please download, complete, and bring to your first appointment the following Forms:
Click Here to download and complete the Child/Adolescent Form
Of course, I will answer any questions you have about the forms. I look forward to working with you soon.
Jim Ciraky PhD., LPC