Below are some forms that need to be filled out my any new client.  To access these forms please click on the red link.  The following forms need to be read and filled out by every client prior to receiving services:

Information and Agreement

New Patient Questionnaire

Notice of Privacy Practices

Receipt of Privacy Practices

Credit Card Authorization

If the client will be a minor, a minor consent form must also be completed prior to receiving services. If treatment will be provided to multiple members of the family, an informed consent for couples/families must also be completed prior to receiving services. If there are any outside providers or agencies you wish to allow me to exchange information with, please fill out the release-exchange of information form for every person/agency you wish me to be allowed to speak with.

I will have copies of these forms available at every initial appointment.  However, it will greatly expedite our initial evaluation of you bring these forms already completed.  You may even scan and e-mail the forms to me at kfrancinilcsw@gmail.com.