Forms
Professional Counseling for Professionals
Before you come to your appointment, please consult this list of forms we may ask you to bring. If you have any questions or concerns about any of these forms, don’t hesitate to contact us.
- EQ Self-Assessment
- Roberta Moore Professional Disclosure Statement
- COVID-19 Addendum and Procedures
- Therapy Benefits Form
- New Client Information Policy and Informed Consent for Treatment
- Credit Card Authorization Form
- Medical Release Form
- Client Intake Form
- Physician Approval Form for Hypnotic Conditioning
![]()