FOR NEW & CURRENT CLIENTS

Everything you need,
in one place.

A few clear resources to help you feel prepared, informed, and at ease as we begin.

A FEW THINGS BEFORE WE MEET

Before your first session.

Please complete and bring these forms to your first appointment, or fill them out electronically beforehand. This gives us more time to focus on you when we meet.

YOUR PRE-SESSION CHECKLIST

Four helpful documents

4 DOCUMENTS
01

General Intake Form

Required

Background information, health history, and what brings you to therapy.

PDFDownload form
02

Mental Health History

Previous therapy experience, medications, and relevant mental health history.

PDFDownload form
03

Emergency Contact Form

Required

Contact information to support your care in case of an emergency.

PDFDownload form
04

Therapy Agreement

Review the scope of therapy, confidentiality, fees, and our working relationship.

PDFDownload form

CLEAR INFORMATION, CAREFULLY HELD

Your privacy, protected.

Your privacy and confidentiality are fundamental to our practice. These documents explain your rights and how we protect your information.

PDF DOCUMENT

HIPAA Notice of Privacy Practices

Your rights regarding protected health information and how it may be used or shared.

Download HIPAA Notice ↓

YOUR RIGHTS AT A GLANCE

Your health information is treated confidentially.

You may access or request an amendment to your records.

You can request an accounting of certain disclosures.

CONFIDENTIALITY & YOUR CAREWhen we’re required to share information

While we maintain strict confidentiality, there are limited circumstances where we are legally required to disclose information:

  • Imminent danger to yourself or others
  • Child, elder, or dependent adult abuse or neglect
  • Court-ordered subpoena or legal process
  • Consultation with other healthcare providers (with consent)
  • Professional licensing board inquiries

We will inform you of any mandated disclosure unless legally prohibited from doing so.

A FEW THINGS YOU MAY BE WONDERING

Questions,
answered gently.

In a crisis or emergency, call 911, go to the nearest emergency room, or call or text 988.

Do I need to fill out forms before my first appointment?+

You can fill them out before or bring them to complete at your appointment. Completing them ahead of time helps us use your first session more effectively for getting to know you and your needs.

Is my information really confidential?+

Yes. Your health information is protected under HIPAA and our privacy practices. Limited exceptions include safety concerns, abuse or neglect, and certain legal requirements. See the HIPAA Notice for details.

Can I request my records?+

Yes. You have the right to access and request copies of your therapy records. There may be a small copying fee. Submit requests in writing with your signature.

What should I do in a crisis or emergency?+

If you’re in immediate crisis or danger, call 911 or go to your nearest emergency room. You can also call or text 988. Emergency resources are included in client materials.

HERE TO HELP

Questions about the forms? Call (123) 456-7890 or email hello@harborpaththerapy.com.

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