Paperwork

Prior to your first appointment there are some documents for you to read and fill out.

 

For Individuals

These forms you will need to print out and fill out to bring with you to that first session: 

1. New Client Information Form

2.  Symptom Checklist

These two documents you will need to read over, especially the informed consent. These will remain on the website, so you don’t have to print them out. You and your therapist will review these documents in your first session, and you'll have an opportunity to ask any questions you might have. 

1. HIPAA Notice of Privacy Practices

2. Informed Consent and Authorization to treatment

If you have health insurance that you are planning to use, please email a copy of the front and back of your insurance card, and your date of birth to info@fleurishpsychotherapy.com, at least 48 hours prior to your intake appointment. 

 

For Couples

These forms you will need to print out, fill out together, and bring with you to your first session: 

  1. New Couple Form

  2. Gottman Disclosure

  3. Gottman Recording Release

These two documents you will both need to read over, especially the informed consent. These will remain on the website, so you don’t have to print them out. You and your therapist will review these documents in your first session, and you'll have an opportunity to ask any questions you might have. 

1. HIPAA Notice of Privacy Practices

2. Informed Consent and Authorization to Treatment

We do not accept health insurance for couples therapy.