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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