GET BUSY LIVING

Going beyond traditional types of talk therapy

NEW CLIENT FORM

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Name
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Phone Numbers

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Emergency Contact Information

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This form can be read here: Outpatient Services Contract

By typing my name in the field below, I agree it is equivalent to my signature on this document and that by doing so, I acknowledge I have read the office polices and procedures described in the Outpatient Services Contract and agree to them.
This form can be read here: HIPAA Notice of Privacy Practices

By typing my name in the field below, I agree it is equivalent to my signature on this document and that it acknowledges I have received the HIPAA Notice of Privacy Practices.

But we know it is only when words move us to act that they reveal their strength.
In what we do . . .

We are always before another beginning.

- Author Unknown