CLIENT FORMS

After making your very first appointment for either group, individual, family, or couples therapy, please download and complete the appropriate form(s) to bring with you for your initial intake session.

If you have any questions or difficulties please call us at 512-472-7878, Monday through Friday, 9am-5pm. If you are unsure which form to fill out please speak to someone at My Healing Place and we will happily guide you to the appropriate form(s).

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Adult Intake Form

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Child/Adolescent Intake Form
Parents seeking services for their child should complete download and complete this form. We ask for one form for each child be completed.

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Family Therapy Form
This form is for families that will meet together at the same time with the same therapist for therapy services. We ask each family member complete a form.

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Couples Therapy Form
We ask each individual complete a form.

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Release of Information Form
If you are seeing another health professional and wish us to be able to contact them, we must have this form on file in order to communicate with them. This is often beneficial if you are in group and seeing and individual, or for health problems which might be/become a factor.

If you wish to email your forms to us, please be aware that email is not considered a secure form of communication and we can not assure confidentiality.

If you were looking for a volunteer or internship form please click here.

ANNOUNCEMENTS

Night Out with Zach-Scott's
"Next to Normal" to Benefit MHP
02-23-2012

'Grief to Peace' Series
Khris Ford speaks with the ‘Grief to Peace’ Project Series January 24, 2012.

Settling Into Our New Home
As of January 9th, 2012 My Healing Place is now at 8401 Shoal Creek Blvd. Austin, TX 78757.

Finding My Way: A Retreat for Adults Who Are Grieving
This weekend retreat will include time for presentation, quiet reflection, small group discussion, song, and use of the other expressive arts.

CLIENT FORMS

ANNOUNCEMENTS

MY HEALING PLACE

8401 Shoal Creek Blvd. Austin, TX 78757

(512) 472-7878

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