Service Forms

Questions? Please contact us at hello@mycenteredself.com before signing.


New Client Forms

New Client Info
Required for all new clients
download here

Services Agreement
Required for all new clients
download here

Telehealth Consent
Required for all new clients
download here

Parental Consent
Required for clients 17 years old and younger
download here

Notice of Privacy Practices
Please read – does not require signature
download here

Consent to Share Records
Optional – let’s discuss if you’re interested
download here


Clinical Supervision Forms

Supervision Agreement
Learning agreement between clinician and supervisor
download here