Shirley Jean Schmidt, MA, LPC - Psychotherapist

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Psychotherapy Intake Forms

If you are interested in becoming a new client, call or e-mail me for a preliminary interview. I interview everyone who wants to start therapy with me, to ensure that I am the right person to provide the requested help. At those times I cannot take new clients, I do keep a waiting list. If we talk on the phone and decide to begin therapy, print out and fill out these forms, and bring them in to the first session.

As a Word file: intakeforms.doc
As a pdf file: intakeforms.pdf