Margaret Neal, LCSW
Client Forms
Some of these forms will be needed for your first therapy session. Fill out only the forms that I indicated that you would need. Please bring the completed forms to your first session.
FORMS FOR A CHILD CLIENT
Acknowledgement of Receipt of Privacy Practices
Child Info Sheet
Child Medical History
General Consent for the Treatment of a Minor
HIPAA- Notice of Privacy Practices
Informed Consent
Limitations of Confidentiality in Couple and Family Therapy
FORMS FOR AN ADULT CLIENT
Acknowledgement of Receipt of Privacy Practices
Adult Info Sheet
Adult Medical History
HIPAA- Notice of Privacy Practices
Informed Consent
Limitations of Confidentiality in Couple and Family Therapy
Margaret W. Neal, LCSW
3400 Central Avenue, Suite 310
Riverside, CA 92506
Phone: 951-367-9502
Fax: 951-781-9084
margaretneal@verizon.net
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