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History and Intake Forms

Please complete the relevant intake and history forms prior to your first appointment and bring them with you when you come.  Note: Please check with your insurance company to determine if your plan requires pre-authorization for psychotherapy or psychological testing.

These forms are in Adobe PDF format. If your computer already has Adobe Acrobat Reader (and most do these days), the form will display when you click on it. You may then print it. If it does not display, you can download a free version of the Adobe Acrobat Reader from the Adobe website.

Click here to go to the Adobe site  (The link for the free reader is near the bottom of that web page.Adobe Reader Logo

Optional Questionnaires for all Clients:

Insurance Benefit Worksheet

This worksheet is designed to help you get the most from your insurance policy. Many insurance companies now require pre-authorization for mental health services. Those that do rarely back date an authorization, so please call your carrier before your first appointment to be sure. Some insurance companies now use a "third party administrator" or TPA to handle mental health benefits.

Note: If there is a secondary insurance carrier, Georgia law dictates that the insurance of the policy holder with the earlier birth date (the birth month, not the birth year) will be the primary polic

Supplemental History Form for Adults for Past Life Therapy (choose the format you want):