Forms

Couples intake packet for psychotherapy

Nancy De Haas's Release of Information form

Church Scholarship Client Agreement form

*To connect with Nancy using telehealth technology for your regularly scheduled appointment please visit: www.doxy.me/dehaas

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

*Courtney Hanks, LICSW, PIP:

Couples intake packet for psychotherapy

*To connect with Courtney using telehealth technology for your regularly scheduled appointment please visit: www.doxy.me/chanks

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

*Heather Roberts, LICSW, RPT™:

Request/Authorization for Release of Information form

*To connect with Heather using telehealth technology for your regularly scheduled appointment please visit: www.doxy.me/heatherrobertslicsw

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

*Lesley Neely, MA, ALC, NCC:

*To connect with Lesley using telehealth technology for your regularly scheduled appointment please visit: https://doxy.me/lesleyneely

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

*Maria Stansbury, LMSW:

Pastoral Care Intake packet

Good Faith Estimate - English

Good Faith Estimate - Spanish

*To connect with Maria using telehealth technology for your regularly scheduled appointment please visit: https://doxy.me/mariastansbury

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

*Angie McDonald, MA, Pastoral Counseling

Certified NeurOptimal® Trainer

NeurOptimalo® Neurofeedback Intake

*Caleb Dykes, MA, ALC:

Child intake packet forpsychotherapy