Forms for New Clients

These forms must be completed and brought with you to your first appointment.  You may return them by mail or fax to 402 564-1799.   If you should forget the intake or consent form, they must be completed before the counseling session begins.  The Privacy Practices is for you to keep.

 

 

New Client Intake
New Patient adult intake.pdf
Adobe Acrobat document [39.4 KB]
Consent for Treatment and Statement of Understanding
Statement of Understanding.doc
Microsoft Word document [31.5 KB]
Notice of Privacy Practices.doc
Microsoft Word document [42.0 KB]

 

Sharon Nyffeler, M.S.

3058 33rd Avenue

Columbus, NE  68601

 

402 563-1422

 

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Sharon Nyffeler, M.S. ~ 3058 33rd Avenue ~ Columbus, Nebraska 68601 ~ Phone: 402 563-1422 Sharon@GoalDirectedLiving.com © Sharon Nyffeler, M.S.

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