Home  / Rates & New Client Forms
Rates
  • Average Cost (per session): $150
  • Sliding Scale: No
Accepted Payment Methods
  • Venmo Only

New Client Forms

If you would like, you can fill out the intake paperwork before your first visit.

Just right click on the file link and you can "save link as" to your computer. Open with Adobe Reader and fill out the fields. You can then email the form as an attachment to fjax.lcsw@gmail.com or you can print, sign, and bring to your first appointment.

Electronic Intake Form with Fillable Fields

If you prefer, we have a plain print version you can fill out by hand, click here to download and print.

Both options require Adobe PDF Reader. If you do not have it installed on your computer, you can click here for a free download from Adobe.com