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Forms
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Please fill out the applicable forms below and bring them
to your first therapy session. Thank you.
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- Client Intake Form
- Credit Card Authorization Form
- Limits of Confidentiality
- Informed Consent
- Cancellation Policy
[/et_pb_text][/et_pb_column][et_pb_column type=”1_4″][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built=”1″ specialty=”off” _builder_version=”3.3.1″ background_image=”https://drelaynedaniels.com/wp-content/uploads/2018/08/home-paralax3-4.jpg” parallax=”on” parallax_method=”off” custom_padding=”150px||150px|” custom_padding_tablet=”50px||50px|” custom_padding_last_edited=”on|tablet” prev_background_color=”#ffffff” global_module=”1967″][et_pb_row global_parent=”1967″ _builder_version=”3.3.1″ gutter_width=”2″ padding_top_2=”50px” padding_right_2=”39px” padding_left_2=”39px” background_color_2=”rgba(255,255,255,0.6)” padding_bottom_2=”50px” use_custom_width=”on” custom_width_px=”700px” background_color=”rgba(247,247,247,0.75)” padding_bottom_1=”10px” custom_padding_phone=”|10px||10px” custom_padding_last_edited=”on|phone” padding_1_phone=”|10px|10px|10px” padding_1_last_edited=”on|phone”][et_pb_column type=”4_4″][et_pb_text admin_label=”Contact me today for your free consultation.” global_parent=”1967″ _builder_version=”3.15″ text_orientation=”center” header_2_text_align=”center” header_4_text_align=”center” header_4_text_color=”#405f7f” header_4_font=”Muli|600|||||||” header_4_font_size=”48″ text_font=”Muli|300|||||||” header_2_font=”Muli|600|||||||” text_font_size=”20″ header_4_font_size_tablet=”36″ header_4_font_size_last_edited=”on|desktop” header_2_font_size_tablet=”24″ header_2_font_size_last_edited=”on|desktop” header_2_font_size=”30px” text_text_color=”#4b4b4b” header_2_text_color=”#424242″ module_class=”CTABottom”]
Contact me today for your free consultation.
I can help you attain the personal growth you truly desire.
888-888-8888
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