Client Forms

If you do not receive an invitation for the patient portal to complete the needed paperwork, or would rather not use it, please complete the paperwork below. You do not need to complete both the portal and forms below.

Client Psychotherapy Intake Forms

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, click here.

 

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32 E McGovern Ave , PA
Lancaster, PA 17602

jeffrey@lancpastoralcounseling.com
(717) 392-1007

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