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Please complete the appropriate form for your specific clinician prior to your first appointment:

*Nancy De Haas Dunn, LPC-S:

Adult intake packet for psychotherapy 

Child intake packet for psychotherapy

Couples intake packet for psychotherapy

Nancy De Haas Dunn's Release of Information form

Church Scholarship Client Agreement form

Pastoral Scholarship form

*To connect with Nancy using telehealth technology for your regularly scheduled appointment during COVID-19: 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:

Adult intake packet for psychotherapy

Child intake packet for psychotherapy

Couples intake packet for psychotherapy

Pastoral Scholarship form

*To connect with Courtney using telehealth technology for your regularly scheduled appointment during COVID-19: 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:

Adult intake packet for psychotherapy

Child intake packet for psychotherapy

Request/Authorization for Release of Information form

Pastoral Scholarship form

*To connect with Heather using telehealth technology for your regularly scheduled appointment during COVID-19: www.doxy.me/heatherrobertslicsw

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

FORMS

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