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Offices In:
4425 E. Agave Rd., Bld. 4
Suite #115
Phoenix, AZ 85044

2111 E. Baseline Road
Suite F-4
Tempe, AZ 85283

We provide phone therapy for your convenience.

Initial Forms

It saves time the first visit to fill out the forms in advance.  Please print the forms and bring with you to the initial appointment.  The following forms are in pdf format.  If you are unable to open them, you may get the current version of Adobe Acrobat Reader at the Adobe site.   If you are unable to print the forms out in advance or prefer to arrive 20 minutes early to fill out the forms, please let us know so that we will have forms waiting for you in the lobby or we could email you the forms.  If anything comes up that would cause you to need to cancel or reschedule, we would appreciate you letting us know as early as possible.  Thank you!

Kim’s initial visit forms:

Intake Packet for Adult Clients: 
This packet is for adult clients who are seeking in-office or in-home therapy.  This packet includes everything you will need for the first appointment.  For couples, there is no need to print out two copies of the forms as long as you each sign where appropriate.  Please print out two "couple's scales" and an extra “treatment plan,” though (see single forms below) and fill those out separately.  For clients who want to use credit card for the first appointment I ask that I am provided with the credit card information at least a day before the appointment for verification.  Otherwise please come prepared with cash or check for the first session. 

Intake Packet for Minors:
This packet is for minors who will be seen either in or out of office.  This packet includes everything you will need for the first appointment.  For clients who want to use credit card for the first appointment I ask that I am provided with the credit card information at least a day before the appointment for verification.  Otherwise please come prepared with cash or check for the first session. 

Formas en espanol:
Este paquete es para clientes que buscan terapia en la oficina.  Este paquete incluye todo lo que usted necesitara para la primera cita.  Para parejas, por favor cada uno de ustedes completen una escala de pareja y los dos deben firmar el permiso de tratamiento (la forma de 4 paginas). Si gusten llenar otro plan de tratamiento (uno cada individuo), pueden encontrar la forma abajo donde dice “single forms.”Los clientes que deseen usar tarjetas de crédito para la primera cita le solicito que proveen la información de la tarjeta de crédito por lo menos un día antes de la cita, para verificación.  De otra manera favor de traer dinero en efectivo o cheque para la primera sesión.  Solo aceptamos dinero en efectivo, ordenes de pago (Money order) y cheques personales para cliente que están solicitando un reporte de inmigración. 

 

Matt’s initial visit forms:

Intake Packet for Adult Clients: 
This packet is for adult clients who are seeking in-office or in-home therapy.  This packet includes everything you will need for the first appointment. For couples, there is no need to print out two copies of the forms as long as you each sign where appropriate.  Please print out two "couple's scales" and an extra “treatment plan,” though (see individual forms below) and fill those out separately.  For clients who want to use credit card for the first appointment I ask that I am provided with the credit card information at least a day before the appointment for verification.  Otherwise please come prepared with cash or check for the first session.   

Intake Packet for Minors:
This packet is for minors who will be seen either in or out of office.  This packet includes everything you will need for the first appointment.  For clients who want to use credit card for the first appointment I ask that I am provided with the credit card information at least a day before the appointment for verification.  Otherwise please come prepared with cash or check for the first session. 

 

Single forms:

If preferred, the individual forms may be downloaded and printed, then filled out as needed, by clicking on the appropriate form below.

 

Expert Witness evaluations for immigration clients:

Kim's Intake Packet for Immigration Clients (English): 
This packet is for clients who are seeking an evaluation for immigration.  This packet includes everything you will need for the first appointment.  We ask for half of the amount of the report and the fee for the first session at the initial appointment.  Please come prepared with cash, money order, or check.   

Matt's Intake Packet for Immigration Clients (English): 
This packet is for clients who are seeking an evaluation for immigration.  This packet includes everything you will need for the first appointment.  We ask for half of the amount of the report and the fee for the first session at the initial appointment.  Please come prepared with cash, money order, or check.   

Clientes de inmigración:
Este paquete es para clientes que buscan una evaluación para inmigración.  Este paquete incluye todo lo que usted necesitara para la primera cita.  Pedimos la mitad de la cantidad del reporte y la cantidad de la primera sesion en la primera cita.  Favor de traer dinero en efectivo o cheque para la primera sesión. 

 



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