The questionnaire is designed to build a foundation for therapy. By responding to these questions as thoroughly as you can, you will be:
- Gathering basic information more efficiently and effectively
- Helping me get to know you in a more focused way
- Providing a historical background for present concerns
- Directing attention to key areas
- Clarifying current concerns
- Preparing to develop a therapeutic plan
Your responses are strictly confidential and protected to the extent of the law. No portion of the questionnaire will be released to others without your permission, except if required by law.
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NOTE: Please print and complete this form and bring it with you to our first appointment.