Intake and Consent Information

Online Client File Disclosure

Here at the Mind in Motion, we utilize TherapyNotes for online client files, a confidential software where your files are keep secure. However, we do understand the risks of keeping files online in todays world, and during our initial sessions together we will discuss the platform and the risks you take in working with our Center through informed consent and confidentiality forms. 

Intake Forms

Counseling Intake Form (Adult)

Counseling Intake Form (Child under 18)

Mental Performance Intake Form

Financial Form

Informed Consent Forms

Clinic Information and Client Policy Forms

Telemental Health Form (if applicable)

Authorization to Release Confidential Information (Please complete authorizations for your therapist to coordinate care with your primary care doctor and other mental health providers.)

We are happy to answer any questions you have about any of these forms. Please e-mail or call us with any questions or concerns. You and your therapist will discuss these forms during your first session. 

If you do not have access to a printer for the paper forms or do not complete them prior to your visit, we have these forms available in the waiting room and just ask that you come about 15 minutes early to allow yourself adequate time to complete them. If you do not complete our online forms we will spend part of your intake session completing those documents online.

Thank you and we look forward to meeting you at your first visit!