Intake Forms

Intake Forms for Dr. Walker:

Please print and sign the Professional Disclosure Statement below for Dr. Walker. Additionally, depending on the type of counseling service you are seeking, please also print the appropriate forms below and bring them with you to your first session completed:

 

Provider professional disclosure statement:

Individual adult counseling or life / career / wellness coaching:

Individual child / adolescent counseling:

Couples / marriage counseling:

Biofeedback, relaxation training, or pain / illness / disability management:

If you have a medical / other mental health provider or other appropriate entity you wish for us to communicate with and coordinate your care, please also complete the following form and bring it with you to your first session.

 

Note: You will need Adobe Acrobat Reader to open the intake forms which are in PDF format. To download Adobe Acrobat Reader for free, click here.