Paperwork

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

These forms you will need to print out and fill out to bring with you to that first session. If you are a couple, each partner should fill out their own New Client Information Form and Symptom Checklist: 

1. New Client Information Form

2. Financial Policy (individual and couples counseling)

    Financial Policy (group therapy)

3. 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 Blue Cross Blue Shield/Anthem 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.