If this is your first visit to Dr. Judith, you will have several pages of information to fill out before your session.   If you can do this in advance, it will not take up your session time with your counselor(s).  Each person receiving counsel must completely fill out his or her own Personal Inventory which gives us an indication of everyone's background.  This inventory is personal and completely confidential.  Information is not shared unless required by law.    Then each person must initial and sign the Informed Consent Agreement which informs you of our services and what to expect.  Please initial each section where indicated.   Only the person responsible for payment (head of household) should fill out the Schedule of Fees page.  Please bring the appropriate completed copies with you to your first session. 

To print or download a PDF file, click on the appropriate form to the left.

FWI... When finished with each file, click on the back arrow rather than the red X which takes you from the website.


 

 

 

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Informed Consent Form

Personal Inventory (Confidential)

Schedule of Fees

Map (Printable)