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
A preparation fee of $22.88 is required for record requests if records are sent to another provider.
The federal HIPAA regulations prohibit charging a fee when providing records directly to the patient or client.
A preparation fee of $70 is required for treatment summaries and approved special 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.
Download and review this form BEFORE your first session. Click here to complete.
Download and review this form BEFORE your first session. Click here to sign.
Download and review this form BEFORE your first session. Click here to sign.
If you have a record, letter or treatment summary request, complete this form to submit.