New Clients
Please fill these forms
out prior to your first appointment. This will help us reach your goals in a
much timelier manner. Thank you! New Client Form
This form has all of your
identifying information and your insurance information; you will also need to
bring your insurance card if you have it, so we can make a copy.
Client Intake Adult
This set of forms helps us
to answer questions we may have about many different areas of your life, from
your childhood to your current functioning. Although it is long, its detailed
nature allows us to make sure we don’t have to ask you too many questions
during our sessions, so that we may focus more on your goals and your solutions. This
intake also includes a complete alcohol and drug screening. The time it takes
to fill out this inventory is unique to you, but the time you take to fill it
out is very much appreciated.
Child Intake
This is a set of forms has
been adapted to account for a child’s age and reading level and asks child-appropriate questions. Please help your child fill this out. There are no right or wrong answers.
Burns Anxiety Inventory
The Burns Anxiety
Inventory was developed by David Burns to help screen clients for anxiety
symptoms. The screening is designed as a tool to assist you in determining how
badly the listed symptoms or problems have bothered you in the past. We use
this to help us determine if these symptoms could be part of the things
standing in the way of reaching your solutions. The inventory takes about 5
minutes and is greatly appreciated.
Beck Depression Inventory
The Beck Depression
Inventory is a widely used self-report, 21 multiple choice questionnaire used to
assess a person’s depressive symptoms. This tool was developed by Dr. Aaron T
Beck. This tool helps assess how badly
these symptoms might affect a person’s life. We use this tool to help us
determine if these symptoms could be part of the things standing in the way of
you reaching your goals. The inventory takes about 5 minutes and is greatly
appreciated.
Policies and HIPPA
This explains the policies
of Gapp Counseling Services and the Health Care Information Privacy Policy
Administration. Please read the form; it will help you understand details on privacy which will be discussed during your initial session.
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 Updating...
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