Please fill out select forms after we have completed an exploratory call. I will let you know at that time what forms are needed.  

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General Disclosure and Information Form

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Parent Consultation Form​

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Child and Family Background Questionnaire (for Minor Children)

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Teen/Young Adult Questionnaire

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Adult Intake

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2e Symptom Checklist

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Pediatric Symptom Checklist (age 6-14)

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HIPAA and WA State Privacy Practices Notice

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Release of Private Health Information Form