Therapy Forms | Molohon Counseling

top of page

Therapy Forms

Here, you will find all the necessary forms to help you get started on your personal counseling and therapeutic journey. Please take a moment to download and complete the required documents before your appointment. If you have any questions, feel free to reach out for assistance :)

Client Intake Form

Gathers your basic personal, demographic, contact information and contact preferences.

Psychosocial History

Gathers more specific background information on your history, symptoms, and functioning.

Informed Consent Form

Outlines therapy expectations, rights, risks, benefits, confidentiality, and limits to confidentiality.

Telehealth Consent

Consent to utilize virtual technology, including risks and limitations to conducting remote therapy.

Notice of Privacy Practices - HIPAA

Explains how I will handle your client health information and your rights under HIPAA.

Release of Information

Authorization to share information with your chosen third parties (e.g., schools, doctors, other therapists).

bottom of page