Forms

These are downloadable PDF copies of our intake paperwork.  We hope that they will make the intake process faster and more convenient for you.  If you prefer to fill out your forms in advance, you can download them here and bring them with you.  The first three forms are for all clinicians in the group.  Below that are personalized forms.  Please download the first three forms and any forms listed under your therapist’s name.

Group Forms

Pollock Group – Client Registration Form

Pollock Group – Financial Policy Agreement

Pollock Group – Personal Data Survey

Therapist-Specific Forms

Dr. Ann Becker-Schutte:

Mimi Steinhaus, MA, PLPC