To complete the INTAKE FORM FOR TRADITIONAL THERAPY services, click here. This form will be automatically submitted. Please complete one form for the primary client, and one for each adult who will be participating in treatment.
If you will be receiving an intensive, please fill out the Full/Partial Intensive Intake Form below. Right click on the form to complete with Adobe Reader or print and complete by hand. You may either email the form to firstname.lastname@example.org or mail it to Family Restorations at 23792 Rockfield Blvd. Ste. 290, Lake Forest, CA 92630.
All new clients must print and sign the Limits of Confidentiality/Therapy Cancellation Policy.
If you would like your therapist to coordinate care with another provider (for example, your psychiatrist, primary care physician, teachers, etc.), complete the Authorization to Disclose Information Form to authorize release of psychotherapy information.
|Full/Partial Intensive Intake Form|
|Limits of Confidentiality/Therapy Cancellation Policy|
|Authorization to Disclose Information Form|
Note: To download Adobe Acrobat Reader for free, click here.