Invest in yourself.
Initial Forms
Please print the forms and email them to your therapist prior 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 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!
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This packet is for adult clients who are seeking 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” and fill those out separately.
Click on each link below to download your forms. Please keep in mind that some forms specify which clinician they are for.
General Adult Intake Forms
Print 2 for Couples
Walk and Talk Therapy
Walk and Talk Form - (Kim Romen Clients Only)
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This packet is for minor who are seeking therapy. This packet includes everything you will need for the first appointment.
Click on each link below to download your forms and email them back to your therapist (Matt’s email is matt@counselingphoenix.com or Kim’s email is kim@counselingphoenix.com). Please have both guardians sign or include custody papers if only one parent is the medical decision maker.
Children’s Intake Forms
Print the following forms as well if applicable:
Walk and Talk Therapy
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Pagina demografica para adultos- Espanol
Pagina demografica para ninos- Espanol
Consentimiento para tratar- Espanol
*Imprime 2 si es para pareja
Credit Card Authorization - Español
*Imprime 2 si es para pareja
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Español
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.
Immigration Fees and Policies Español
Consentimiento de tratar- Espanol
Autorización de la Tarjeta de Crédito
Escala de depresion
Escala de ansiedad
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
Anxiety Scale
Depression Scale
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The following are some common handouts that we would like to have available to you.
Legal:
General:
Automatic Negative Thoughts (ANTS)
Anxiety Scale
Depression Scale
For couples: