LKZ THERAPY, LLC
  • Home
  • About Lori
  • Services
  • Intake Forms
  • Fees
  • Office Information
  • Contact Me
  • Therapy Resources
    • Blog
    • Book Recommendations
    • My Podcast!

Intake Forms

These forms are for authorized clients only!

Please print each of these documents and bring a completed copy to our first appointment. This step will significantly reduce the paperwork portion of your first appointment. 
​

informed_consent.docx
File Size: 22 kb
File Type: docx
Download File

privacy_notice_and_acknowledgment.doc
File Size: 43 kb
File Type: doc
Download File

fee_and_insurance_information_agreement_jcb_therapy_llc.docx
File Size: 15 kb
File Type: docx
Download File

lori_roi_.doc
File Size: 35 kb
File Type: doc
Download File

credit_card_auth.docx
File Size: 13 kb
File Type: docx
Download File

Proudly powered by Weebly
  • Home
  • About Lori
  • Services
  • Intake Forms
  • Fees
  • Office Information
  • Contact Me
  • Therapy Resources
    • Blog
    • Book Recommendations
    • My Podcast!