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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
Credit Card Authorization
Click the links below to download intake forms:
To download Adobe Acrobat Reader for free, click here.
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