Intake Forms

If you're a new client, please complete the following forms and bring them to your first counseling session. Couples - Both partners must each complete an intake packet as well as the attachment assessment.

Please read through the forms below. You do not need to necessarily print them out, they are for your information and consent. Acknowledgement that you have read the privacy practices is included in the New Client Forms. A hard copy is also available in the waiting room, should you choose to read through them prior to your first appointment.

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 information:

Schatzi Counseling is a training center for counselors. Counselors at Schatzi Counseling, at a minimum, are upper level masters and doctoral students who have completed considerable coursework and are accumulating clinical experience. An important part of this clinical training involves having a Clinical Supervisor observe student’s work as well as having students observe other students and counselors work. This is done in two ways. Sometimes supervisors or students observe therapy sessions live via camera. Other times sessions are recorded on video or audio tape for later playback in individual or group consultations sessions. The use of observation and tapes insures that the therapy you receive is of the absolute highest quality.

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

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Helpful Forms

Click here to view and print forms for your appointment.