COUNSELING TUCSON

Specializing in Emotional Transformation Therapy (ETT™)

Same Day Appointment Possible • Individuals and Couples Over 18 • LGBTQ Welcomed

Make Appointment by E-mail or Call 520-333-2193


If you would like to use our time together for therapy instead of paperwork, you are welcomed to fill out the forms electronically using Adobe Acrobat Reader DC at home (Google it to download this free application that allows you to type anywhere on any pdf file), email them to me 48 hours before your first session, print them out to hand sign and bring the hard copies with you to the first session. If you prefer that I learn this information through conversation with you and fill the forms out for you as we go, I will be happy to do that, as well.


FORMS REQUIRED BY FEDERAL REGULATIONS AS WELL AS FOR BACKGROUND AND EFFICIENT USE OF CLINICAL TIME TOGETHER :

INTAKE & CONSENT INFORMATION (45 minutes to fill out)

download, complete with Acrobat Reader and PRINT


HIPAA PRIVACY POLICIES • READ ONLY


SYMPTOMS AND BODY CHART (20 minutes to fill out)

download, fill out with Acrobat Reader and PRINT


MEDICARE INFORMATION (IF APPLICABLE) •

download, fill out with Acrobat Reader and PRINT

(IMPORTANT: please return this form by email 1 WEEK before your first session

if you'd like your coverage for treatment verified)