New Client Forms

Welcome New Client,

New Client Forms: Below is information related to Illinois state laws rules and regulations in regards to therapy.  In addition, there is basic information regarding this practice. Please, read the information carefully and feel free to contact me for any clarifications.

Welcome again, and I  am looking forward to seeing you for your first session.

New Client Forms:

For Telehealth users, please print and/or fill the Fill NDP Telebehavioral Health Informed Consent

Please, print and/or fill the “Therapy Agreement”. Bring it with you to our first session. We will discuss its details during your first session.

Word Doc

• New NDP Client Agreement Form 2020-21

PDF

• New NDP Client Agreement Form 2020-21

Please, print and/or fill the relevant form/s and bring them with you to our first session:

Word Doc

NDP_Client_Information_Minor New_2020

• NDP Client Information Adult 202-20210
• NDP Credit Card Authorization one time (if needed-to/from other professionals)

PDF

• Fill NDP Client Information Minor _
• NDP Client Information Adult 202-20210
• Fill NDP Authorization to release information (if needed-to/from other professionals)

Please read the following prior to your arrival, as these links contain additional beneficial information.

Word Doc

• NDP_Practice and Policies_New _2020
• NDP_HIPPA_2020-2021 New

PDF

• NDP_Practice and Policies_New _2020
• NDP_HIPPA_2020-2021 New

In Addition please find the attached worksheets:
ThoughtRecordSheet
ThoughtRecordSheetAnger
ACTworksheet
CBT Triangle
Depression cycles
HealthAnxiety
ProblemGoalFramework
ProblemSolvingWorksheet
SafetyPlan