Therapy Central New Client Information Form

Please print the form below, fill it out and have it ready for your appointment. Thanks!

Client Information Form (There are 3 pages)

Print page 1, 2 and 3 of this form, fill it out as completely as possible and bring it to your first appointment. This will assure you have all the time you need to be thorough with your answers and have access to all the information requested. Thanks!

(Directions for printing: On the gray bar below that says "Macromedia FLASHPAPER" to the left, there is a printer symbol. Push
that icon to print the page you see. On the far right of the same gray bar there are arrows that, when pushed will change the page. When you get to page 2, push the printer icon again to print that page and then again for the 3rd page of this form. Thanks!)