Client Forms

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

Informed Consent & Disclosure for Adults

Informed Consent for Minors

Child Intake Information

Family Intake Information

Finincial Agreement

Notice of Privacy Practices

Authorization to Exchange Confidential Information

Limits of Confidentiality

Yvonne Miller, LMFT
Registered Play Therapist
EMDR


Lic #99234 yvonnemillercounseling@gmail.com
949-838-7289

Send a Message