North Seattle Therapy & Counseling Forms

We use an confidential online registration system for new clients.  Once we have scheduled an intake session, we will send you an email with a link to our registration system, where you will be asked to complete a brief intake questionnaire and review several forms (similar to what you sign at a doctor's appointment):

  1. Treatment Policy and Disclosure Statement (required for all therapists in Washington State)

  2. Notice of Privacy Practices (also required)

  3. Summary of Cancellation Policy (24 hours)

  4. Fee Schedule

We would be happy to answer any questions you have about these forms at our first appointment. Please let us know if you have any questions the process for becoming a client. Our contact information can be found here.

Release of Information:

We cannot exchange or discuss any health information with anyone who is not the client, without a signed release of information (ROI) form. If you would like us to send health information or discuss treatment with another service provider, please complete one of the forms below, and return it to us (in person, by mail, or by fax).