Required New Client Forms
If you are a new client, please complete the following forms and bring them to your first therapy session:
Child Age 2-17 Data Sheet (.pdf)
Child Age 2-17 Client Intake Questionnaire (.pdf)
Adult Data Sheet (.pdf)
Adult Client Intake Questionnaire (.pdf)
All clients need to agree to our Client Agreement and Privacy Policies before working with Renew Wellness. If you have questions, feel free to call and ask questions!
Client Agreement (.pdf)
Notice of Privacy Policies (.pdf)
Optional Forms
If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), please complete this form to authorize the release of therapy information:
Authorization of Release of Information (.pdf)
If you would like to partake in Technology Assisted Therapy using our HIPAA compliant video therapy platform, please print and email the form below or complete the form online:
Teletherapy Agreement (.pdf)