MOUNTAIN LAKE PSYCHOTHERAPY
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Forms

​Please fill out the forms for the type of counseling you are engaging in.
You can find groups by scrolling to the bottom.
Individuals
If you are engaging in individual counseling, please review, complete and sign the following forms.
Couples, Partners or Families 
If you are engaging in couples or family counseling, please review, complete and sign the following forms.
Informed Consent  
Informed Consent 
Intake Form
Intake Form (each adult must complete)
Payment Information
Groups
If you are engaging in group counseling, please review, complete and sign the following forms.
Payment Information
General Forms​ 

Women's Alcohol Use Group Intake

Group Informed Consent


Notice of Privacy Practices

​Good Faith Estimate Notice

​Disclosure of Practitioner Information

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  • Home
  • About Me
  • Forms
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  • Resources