Call: (603) 743-4004

Forms

If you are scheduled for an intake appointment:

Adult clients: Please download the Informed Consent – Adult form and the Adult Intake Questionnaire and bring both completed forms to your appointment.

Adult Couples: Please download the Informed Consent – Adult form and the Adult Intake Questionnaire for each person, and one copy of the Couple’s Confidentiality Agreement, and bring the completed forms to your appointment.

Child clients: Please download the Informed Consent – Child form and the Child Intake Questionnaire and bring both completed forms to your child’s appointment. Please note that BOTH parent’s or guardian’s signatures are required.

If you have any questions about our office policies, please let us know at your appointment.

 

Informed Consent – Adult

Adult Intake Questionnaire

Couple’s Confidentiality Agreement

 

Informed Consent – Child

Child Intake Questionnaire