Intake Documents

Welcome! After you receive a confirmation for your first session with Beatriz Lloret, please complete the following documents and submit them at least a day before our first session through the form below.

Client-Therapist Contract

Professional Disclosure

Client Intake Form

Consent to Record

Online Therapy

SUBMIT YOUR FORMS HERE

Intake Documents Submission Form

Partner 1

First Name

Last Name

Phone

(###)

###

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Partner 2

First Name

Last Name

Phone

(###)

###

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New Client Intake Documents

HIPAA Release of Information Form

Only fill out the form below IF if you and/or your partner are currently working with an individual therapist.

Clich here to acess your HIPAA Release of Information Form

Release of Information

If you or your partner are currently working with an individual therapist, please submit the HIPAA compliant release of information form for collaboration if necessary. Fill out your name and contact in the first filed and the name and contact of your therapist in the fields below.

First Name

Last Name

Name of the Therapist

Therapist's email

Therapist's phone number

(###)

###

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