Susan Romanelli, LCSW
713-818-6881
susan@romanellitherapy.com
HELPFUL FORMS

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Psychotherapy Intake Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form  
   
Authorization to Disclose Information Form  

Note: To download Adobe Acrobat Reader for free, click here.

©2012 by TherapySites.com. All rights reserved.