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New Client Forms

Family on Beach  If you're a new client, please complete the following forms and return them via email, fax or postal mail to the therapist 24 hours before your first scheduled therapy session. Also provide a copy of the front and back of your insurance card if you are wanting to utilize in-network insurance benefits accepted by Tami Applegate MFT.  

 

 
  Client Information and Insurance Form /userfiles/1009961/file/New Client Data Information and Insurance consents.pdf  
  Consent to Treatment Form /userfiles/1009961/file/Intake Consent to Treatment 2020.pdf  
  Telecounseling Consent Form /userfiles/1009961/file/telecounseling informed consent.pdf  
  Client History Questionnaire /userfiles/1009961/file/History Questionaire.pdf  

 

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