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. 

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

Intake Form Adolescent
File Size: 116 kb
File Type: pdf
Download File

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

HIPPA Information
File Size: 93 kb
File Type: pdf
Download File

Release of Information
File Size: 62 kb
File Type: pdf
Download File

Informed Consent for Children
File Size: 90 kb
File Type: pdf
Download File

Telehealth Consent Form
File Size: 56 kb
File Type: pdf
Download File

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