Client Forms

Below you will find some of the forms I require to fulfill my consulting to you. Please click on the the appropriate form, download, fill out, scan and return. I thank you for your inquiry and look forward to speaking with you very soon.

Therapy Agreement

Video & Telephone Release

Client Intake Form

Information Sheet

Limits of Confidentiality

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information




,

angie@angtherapy.com
(612) 251-7551

Got Questions?
Send a Message!

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.