Forms

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

---

Forms to Complete:

• The Intake Form for your specified age range​

What to Bring:

• Form of Identification
• Insurance card(s)

---

Katie Padron, LMSW

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

Download File

---

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

Download File

---

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

Download File

---

Cristina Stauffer, LMSW

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

Download File

---

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

Download File

---

---

Laurie Schmit, LMSW

laurie_schmit_client_forms_2019.pdf
File Size:	96 kb
File Type:	pdf

Download File

---

laurie_schmit_intake_forms.pdf
File Size:	521 kb
File Type:	pdf

Download File

---

---