Forms for Client Couples


The Couples Intake Form is intended to help us understand your relationship and the broader context of your lives from each partner's perspective so that we can support you more effectively. Please have each partner complete their own copy of this form and bring the printed documents with you to our first counseling session. You can either print the PDF version of this form and complete it by hand, or you can fill out the MS-Word version of this form and print the completed form. Click here to download the PDF version of the Couples Intake Form. Click here to download the MS-Word version of the Couples Intake Form.
The Co-Therapy Disclosure Statement defines your rights and responsibilities in our therapeutic relationship. We strongly suggest that both partners review this document before our first counseling session and bring any questions that you may have about the Statement to that session. Click here to download the PDF version of the Co-Therapy Disclosure Statement.
The HIPAA Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. We suggest that both partners review this document before our first counseling session and bring any questions that you may have about the Notice to that session. Click here to download the PDF version of the HIPAA Notice of Privacy Practices.