Forms

Please print and complete the forms for your specified practitioner.
Bring with you to your intake appointment. 

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Forms to Complete:

• The Intake Form for your specified age range​

What to Bring:

• Form of Identification
• Insurance card(s)

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Katie Padron, LMSW

Intake_Child Ages 12 & Under
File Size:	254 kb
File Type:	pdf

Download File

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Intake_Adolescent Ages 13-17
File Size:	283 kb
File Type:	pdf

Download File

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Intake_Adult Ages 18 & Up
File Size:	279 kb
File Type:	pdf

Download File

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Andrea Tramper, LMSW

Intake_Adolescent Ages 13-17
File Size:	276 kb
File Type:	pdf

Download File

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Intake_Adult Ages 18 & Up Packet
File Size:	1460 kb
File Type:	pdf

Download File

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Laurie Schmit, LMSW

laurie_schmit_-_intake_forms-2018
File Size:	365 kb
File Type:	pdf

Download File

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laurie_schmit_new_client_forms_2018
File Size:	199 kb
File Type:	pdf

Download File

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Dr. Kelli J. Cummings, LPC, NCC

Intake_Child Ages 12 & Under
File Size:	261 kb
File Type:	pdf

Download File

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Intake_Adolescent Ages 13-17
File Size:	277 kb
File Type:	pdf

Download File

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Intake_Adult Ages 18 & Up
File Size:	288 kb
File Type:	pdf

Download File

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Cristina Stauffer, LMSW

Intake_Adolescent Ages 13-17
File Size:	638 kb
File Type:	pdf

Download File

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Intake_Adult Ages 18 & Up
File Size:	837 kb
File Type:	pdf

Download File

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