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PhoenixWay to Holistic Natural Health

intake forms

​To save time during your initial mental health counseling appointment to focus more on helping you, please click on the links below to complete the following intake forms online before your first session.   

Please complete forms 1-4.  #5 is for your reference.  #6 is optional, only if you want PhoenixWay to share your PHI with others.  Copies of completed consents (#'s 1-3 and 6) will be sent to your e-mail address.
1. Professional Disclosure  //  2. Consent for Treatment  //  3. Financial Agreement
4.  Mental Health Counseling Self-Assessment
5. HIPAA Notice of Privacy Policies // 6. Authorization to Disclose PHI

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  • Home
  • About
    • Why the Phoenix?
    • Testimonials
    • My Office
    • Services & Fees >
      • Scholarship Program
  • Counseling, Coaching & Consulting
    • Mental Health Counseling >
      • Holistic Psychotherapy
      • Trauma Therapy / EMDR
      • Clinical Hypnotherapy
      • HeartMath / Biofeedback
      • Tapping / TFT / EFT
    • Transformation Coaching >
      • My Approach
      • Traditional Naturopathy
      • Plant Based Lifestyle Coaching
    • EMDR Consulting
    • Distance Sessions
  • Other Services
    • Yoga & Yoga Therapy >
      • IYT / Kripalu Yoga
    • Taiji & Qigong
    • Meditation
    • Reiki
    • Public Speaking & Seminars
  • Resources
    • Downloads >
      • My Books
      • FREE Downloads!
    • Natural Living & Healing >
      • CBD Therapy
      • Grow Your Own Food
      • Healing Centers
      • Off the Grid
      • Ecovillages
    • Rover Scouting 4 Adults
  • Connect
    • Blogs >
      • PhoenixWay Vlog/Blog
      • Psychology Today Blogs
      • Good Therapy Blog
      • IIN Health Blog
    • Intake Forms
    • Wellness Surveys >
      • Women's Wellness Survey
      • Men's Wellness Survey
      • Wellness Survey Update
    • Wellness Partnerships