Forms for Clients 

If you are a new client, please print, complete, and bring the intake packet that corresponds to your age group or therapy type with you to your initial appointment. 

Please complete the forms as thoroughly as possible. 
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New Client Packet - Child

New Client Packet - Teen

New Client Packet - Adult

New Client Packet - Family Therapy

New Client Packet - Parent Consultation

Additional Forms and Information

Release of Information

This form authorizes the release of information to other involved medical providers, school personnel, and individuals in a client's life. Please complete and bring this form with you if you would like your therapist to coordinate care with any of the above listed professionals. 
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Privacy and Confidentiality Information

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Exceptions include: 

• Suspected child abuse or dependent adult or elder abuse. We are required by law to report this to the appropriate authorities immediately. 
• If a client is threatening serious bodily harm to another person/s, we must notify the police and inform the intended victim. 
• If a client intends to harm himself or herself, we will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, we will take further measures without their permission that are provided to therapists by law in order to ensure their safety (this typically involves hospitalization or an assessment through mental health professionals working with the police).

The protection of your health information is very important. As mental health professionals, we recognize that many of the things we discuss are sensitive, and because of this it is important that you are aware of how this information is used and may be revealed.  The document below contains a description about how your protected health information is used and sometimes disclosed.  As healthcare professionals covered under the federal “HIPAA” law, we are required to give you this notice and to abide by its terms. We reserve the right to change the terms of this notice, and if that happens your therapist will provide you with an updated copy with the changes.  Please download Thrive's Notice of Privacy Practices for full disclosure.
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Notice of Privacy Practices