Debbie Gross, LCSW, Ltd. - Individual, Marital & Family Therapy
New Patient Forms
Please click on the links to the forms below, print, and fill out before your first appointment.
  
 


Fill out for all new patients






Fill out for ONLY new child patients







Fill out ONLY for new adult patients     

                            




For minors age 12-17 - print out but do not sign





Required for all new patients

 
 
Additional Patient Forms
  

Release needs to be signed for any collaborative communication between
                                    the therapist and other professionals
 





Please read my Privacy Practices Notice and print out and sign page 5, Signature Page
                                    and bring in to your first appointment
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