Forms

Client Intake Form           

If you're a new client, please complete the following forms and bring them to your first therapy session.          

Consent for Treatment and Limits of Liability Form     

Authorization for Use or Disclosure of Protected Health Information Form 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

ADDRESS

8105 Rasor Blvd. 

Suite 268 

Plano, TX 75024 US

CONTACT US

© 2019 by Cohesion Counseling

Website by STRENGTHS culture

Tel: 817-381-5597

Email: lmichellethomas01@gmail.com