Before your first session, please print out, complete and sign the following forms:

• Client Information form (one for every adult)
• Disclosure Statement (two per adult)
• HIPPA Notice of Privacy Practices (read and keep for your records)
• Child Client Information Form (for children under age 15 )

Please bring completed forms with you to your first session. I will review them with you and answer any questions you may have.

JLC Therapy : 1711 S. Pearl Street : Denver, CO 80210 : 720.939.8399  : Contact Julie :

© 2011 JLC Therapy, Julie Chrzanowski