Click on the links below to print, review, and complete the following forms to bring to your first appointment.
Please feel free to ask any questions you may have prior to signing!
This form covers your basic contact information.
This form provides detailed information about the counseling process, payment options, and more. It also serves as a consent for us to treat you.
This form discusses patient privacy.
This form must be filled out and signed in order to store a credit or debit card to pay for your sessions.
All clients receiving counseling services in the office will be required to sign this form. This document contains important information about our decision (you, your counselor, and SWFL Counseling LLC) to resume in-person therapy in light of the COVID-19 public health crisis.
That's it! Now you're ready for your first appointment.
The following forms are OPTIONAL. You only need to complete them if necessary (Your counselor will let you know if these are needed them from you).
This form is for clients of Lindsay Gomez, who have already scheduled their initial hypnosis session.
This form authorizes the release of protected health information to a designated party.
This form serves to protect a client's protected health information from being released when a third-party is paying for the counseling sessions.
This website (also available in an app format!) will quickly screen you for certain mental health symptoms. Feel free to print the results and bring to your first appointment, or email them to your counselor.