FORMS

Before you attend your first appointment, please fill out the intake paperwork- this includes the Intake and Consent Form.

If you are bringing an adolescent in for counseling be aware that you will need to provide any custody paperwork that may be in place for the adolescent- this is required before beginning counseling.

You may also fill out a Release of Information if you would like to have your records be available for another party such as your health practitioner.

You may submit your paperwork before attending your appointment through email: hollytxlpc@gmail.com

Intake Forms:

Intake Form- Child

Intake Form- Adult

Consent Form:

Consent to Treat Form

    Release of Information:

    Release of Information

    Additional Forms:

    For further assessment of yourself or your child, please refer to these specific forms if they are applicable to your treatment.

    Patient Health Questionnaire (Adult- Anxiety / Depression)

    Patient Health Questionnaire Adolescents (Child- Depression

    ADHD Parent Form

    ADHD Teacher Form

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