Child, Adult and Family Therapy | Kim Lucey, LCSW
971-225-0105

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Please feel free to download and fill out forms prior to your first appointment.  Otherwise, please allow 15-20 minutes to complete intake forms. 

Adult Intake Form
File Size: 121 kb
File Type: pdf
Download File

Child/Adolescent Intake Form
File Size: 119 kb
File Type: pdf
Download File

Informed Consent
File Size: 81 kb
File Type: pdf
Download File

HIPPA Notice of Privacy Practices
File Size: 154 kb
File Type: pdf
Download File

Release of Information
File Size: 87 kb
File Type: pdf
Download File

Informed Consent for Children
File Size: 94 kb
File Type: pdf
Download File

Telehealth Consent Form
File Size: 85 kb
File Type: pdf
Download File

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