Client Forms (coming soon)

If you are new to working with me, please be sure to fill out the following forms, and email or bring them to your first session. This will help ease you in and allow as much time as possible to focus on you. Existing clients can also complete these forms to update or save any information for their records.

Client Intake Form

Personal Health Information to help me get to know all the basics about you, who you are and for insurance or billing purposes

Information Sheet

Some helpful reading materials and resources to get you started until we can meet for our session.

Limits of Confidentiality

Confidentially is ethical in nature and the fundamental intent is to protect a client's right to privacy by ensuring that matters disclosed to a professional not be relayed to others without the informed consent of the client. However, there may be certain things that I am required by law to share. This limitations will be explained in detail here.

Authorization for Release of Information

If you are relocating or feel that you would like to collaborate your session with another provider, simply fill out this form to allow for release of your information

Know & Live Counseling and Consulting, PLLC

5909 W. Loop South, Suite 670

Houston, TX 77401

Phone: (281) 387-2069

Email: info@knowandlivecounseling.com

©2019 by Know & Live Counseling and Consulting, PLLC. Made with Love by XtineBCreative.