To Complete the Necessary Paper Work, You can:

  • Print & complete forms and bring them to your appointment

  • Print & complete forms and fax them to Aimee at: 480-247-5387
     

For Children in Play Therapy For Couples Counseling or Adult Psychotherapy
Intake form for Minors
 *Must be signed by a custodial guardian		 Intake form for Adults
* There are separate forms for adult clients
Collateral Agreement
*For parents willing to participate		  
Psychological Survey of the Child
*Completed by a parent		 Psychological Survey
*There are separate forms for adult clients
HIPPA Privacy Information
*For your records only		 HIPPA Privacy Information
*For your records only

Welcome to our family of patients!

 

 

 

Copyright (c) 2003-2014 True Difference
9855 E Larkspur Dr. | Scottsdale | Arizona | 85260 | E-Mail : aimee@IamDrShort.com
Tel : 480.329.5636