On this page you will find 10 forms. Please read and familiarize yourself with the information that is in each one. If you have questions prior to your session please call me to discuss. However, you only need to print the Client Information form and the Social History. On the Client Information Form, you will sign the back side indicating that the other forms and information have been made available to you and that you understand and agree with that information. If you will be participating in family or relationship counseling the other participant must read, print and sign the Collateral form. Thank you and I appreciate your time in this matter.
Print the following form if you will be a participant in the individuals sessions (family member, partner, parent, etc)
KCS Collateral Agreement May 2018 (pdf)
DownloadDO NOT PRINT ANY OF THE FOLLOWING FORMS (UNLESS YOU WOULD LIKE A COPY FOR YOURSELF)
KCS Child Therapy Contract May 2018 (pdf)
DownloadKCS HIPPA Information Form May 2018 (pdf)
DownloadKCS Electronic Communication Policy May 2018 (pdf)
DownloadKCS Consent to release information May 2018 (pdf)
DownloadKCS Financial Policy (pdf)
DownloadOutpatient Services Contract 10:20 (pdf)
DownloadSTANDARD NOTICE- No Surprises Act (1) (docx)
Download