Helpful Forms

 

 

 

Welcome!  I thank you for giving my practice the opportunity to provide coaching and pastoral counseling services for you and your family. 

As a new client or couple, please review, select, and complete the following forms.  When complete, please bring these documents to your first appointment or fax them to the confidential fax: 1-505-214-0473 prior to your first appointment.


New Client Packet

All new clients and/or couples must complete a New Client Packet which include the following 4 documents:

 
Standard Intake Form 

 New Client Questionnaire

 Goal Setting Worksheet

 
Limits of Confidentiality/Session Cancellation Policy


Subconscious Restructuring
If you are seeking solutions with the following areas, please complete the  Subconscious Perspective Form and the Emotional Checklist.

Depression
PTSD
ADD
Eating Disorders
Obesity
OCD
Anxiety
Stress Management
Weight Management
Anger/Balancing Moods
Temperament Adjustment
Trichotillomania



Authorization to Disclose Information

 Authorization to Disclose Information Form

 To authorize release of your information to coordinate care with another provider, family member, supportive friend;  please review, complete, and return or fax this form to the office.

Schedule an Appointment



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