Forms

Forms

Protection & Consent

Living Hope accepts credit cards, cash and checks. We will provide a "superbill" as an out-of-network provider for possible reimbursement to you from your insurance carrier.


Please fill out and bring in to your first session: Adult History Form, Family Information Sheet, Informed Consent Form and the Authorization to Release Health and/or Confidential Information.


Click on the PDF button to download any forms you may need to fill out.


Informed Consent and Essential Forms for

Kristen Smith, LMFT, LISAC


Informed Consent and Essential Forms for

Erica Gores, LMFT


Informed Consent and Essential Forms for

Erica Gores, LMFT (for Child)


Informed Consent and Essential Forms for

Ashley Worthington, LPC


Informed Consent and Essential Forms for

Molly Caldwell, LMFT


Informed Consent and Essential Forms for

Molly Caldwell, LMFT (for Child)


Informed Consent and Essential Forms for

Julie Caldwell, LMFT


Informed Consent and Essential Forms for

Julie Caldwell, LMFT (for Child)


Informed Consent and Essential Forms for

Kenna McGrath, LAC (with Supervision)


Authorization to Release

Health Information and/or Confidential Information


Start on a new path today!

Call us at 602.448.7912 and find hope.
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