Douglas Gotel, LICSW, RPT-S

Counseling for Children, Teens and Grown-Ups

Required Documents

If you are a new client, please complete an intake package to bring to your first session.


Intake packages contain the following forms:

Client Contact Information

Consent to Services

Social History

Informed Consent - Privacy and Limits on Confidentiality

HIPPA Rights

Release of Information (for service coordination)

Optional Consent to Record (for clinician consultation for best practices)

Behavioral Questionnaires 


Click the links below to download intake forms:

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