Chapin Faulconer LPC
LICENSED PROFESSIONAL COUNSELOR
Helpful Forms

If you are a first-time client, please review and complete the following forms and bring them to your first session.

  • Client Intake Form
  • Notice of Privacy Practices

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, family practitioner, etc.), complete this form:

  • Consent to Release Information Form

 


Consent to Release  
Intake Form  
Notice of Privacy Practices  

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