Client Forms

"I have so much paperwork. I'm afraid my paperwork has paperwork." - Gabrielle Zevin

Youth Counseling Services

If you are seeking counseling services for your child/dependent and would like to begin the intake documentation and schedule an appointment. This is a HIPAA compliant platform.

New Client

Returning Client

Adult Counseling Services

If you are seeking counseling services and would like to begin the intake documentation  and schedule an appointment.  This is a HIPAA compliant platform.


New Client

Returning Client

Referring Agency

If you are referring someone to counseling services through an agency (i.e., Juvenile Probation, Division of Child and Family Services, etc.) you may download and print the referral form here. Please send it to: [email protected]

Referral Form

Group Counseling Services

If you are seeking group counseling services and would like to begin the intake documentation prior to your first scheduled appointment you may download and print the consent form here. Please know, I require an initial intake assessment to be completed prior to group therapy to ensure clinical recommendations are appropriate.

Group Consent Form

What to Expect

"Sometimes the hardest thing and the right thing are the same" - The Fray 

First Appointment: We will complete intake information and talk about what brought you to counseling, which typically takes 2 hours. 


Second Appointment: We will create treatment goals together as a team. You are the expert and author of your story and I will provide clinical expertise.


Treatment: We will work towards the goals we created. The length of treatment is determined based on clinical recommendations. We will discuss this in detail during your first two sessions. 


Every 90 Days: We will review the treatment goals and see what changes, aka Ripple Effects, have occurred. 


Discharge: Counseling is voluntary and you may leave the therapeutic relationship at any time. Discharge planning is established from the very first session and discussed throughout treatment. 



"Every new beginning comes from some other beginning's end." - Seneca

Pahrump

Address: 1321 S. Hwy 160, Suite 3E | Pahrump, NV 89048

Phone: 725-724-5779

Fax: 702-931-9962

Email: [email protected]

Las Vegas

Address: 7495 W. Azure Drive | Las Vegas, NV 89130

Phone: 725-724-5779

Fax: 702-931-9962

Email: [email protected]