Required Forms

If you are interested in learning more about our practice and services, please complete our Contact Form, so we can discuss your needs.

If you have had your free phone consultation and/or your initial email conversation with us, you are ready to get started. Please bring your insurance card and completed forms to your first appointment.

• If you have been assigned a therapist and have your login and password information, please click your clinician’s name below to complete the online registration.

• We are working on having our paper forms included on these links, but for now, please also complete the paper forms listed below.

 

“Behind every good therapist, there is paperwork.”  (we have no idea who said this)

 

For online forms, click your therapist’s name below:

Lisa Brickert, MSW, LCSW

Lisa Marie Carlson, MSW, LCSW

Elyse Dombrowski, MA, LMFT

Jean Hausmann, MSW, LCSW

Haley Jossel, MA, LMFT

Dori Mages, MSW, LCSW

Sarah Rudek, MA, LPC

Mehnaz Siddiqui, MA, LCPC

Kendra A. Vargas, MA, LPC

Please complete these paper forms too:

Intake Forms-Checklist

Consent to Release Information

Developmental History/Current Strengths & Needs- Children and Teens

Developmental History and Current Strengths & Needs- Over 18

Practice Information

HIPAA Privacy Notice