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Forms

INTAKE FORMS

 

New clients must complete forms before the first session to best serve you. Download and save the documents below for your records. For your convenience, after you've read and if you agree, click the links to sign and submit at least 18 hours before the first session. 

RECORDS REQUESTS 

For record requests, a preparation fee of $22.88 is required if the records are sent to another provider.

 

The federal HIPAA regulations do not allow a fee for records provided directly to the patient/client.

A preparation fee of $70 is required for treatment summaries and "approved" letters. GWCC has the right to decline requests for letters regarding a client's legal matters.

 

Click the button below to submit your request.

*Please allow 30 days for turnaround.

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