Intake Forms and Policies
The following forms are used in our practice. It may be helpful to complete them before you come in for your first session. If you have any questions about these forms, we can discuss in session.
Please choose the specific form for your therapist.
Mary Herzog, PhD
Intake forms / Adult (Download to print full set)
- LFT Therapy policies and procedures
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Privacy Practices
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Receipt of privacy practices
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Client intake
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Map and Directions
Intake forms / Child (Download to print full set)
- LFT Therapy policies and procedures
- Privacy Practices
- Receipt of privacy practices
- Child intake form
- Map and Directions
-
LFT Therapy policies and procedures
-
Privacy Practices
-
Receipt of privacy practices
-
Client intake (Both partners complete please. Duplicate copy included in the set.)
-
Map and Directions
Kirk Andrews,
MA, LMFT, BC-DMT
Intake forms / Adult (Download to print full set)
- LFT Therapy policies and procedures
-
Privacy Practices
-
Receipt of privacy practices
-
Client intake
-
Map and Directions
Intake forms / Child (Download to print full set)
- LFT Therapy policies and procedures
- Privacy Practices
- Receipt of privacy practices
- Child intake form
- Map and Directions
-
LFT Therapy policies and procedures
-
Privacy Practices
-
Receipt of privacy practices
-
Client intake (Both partners complete please. Duplicate copy included in the set.)
-
Map and Directions
Additional Individual Forms
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Retainer for Legal Matters
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How to Make the Most of your Couples Therapy
