PRIOR TO OUR FIRST MEETING, I NEED BOTH OF THESE FORMS COMPLETED PRIOR TO YOUR FIRST APPOINTMENT.  

THE INITIAL INFORMATION SHEET IS A FILLABLE FORM. 

THE INFORMED CONSENT TO TREAT FORM SHOULD BE READ AND SIGNED ON THE THIRD PAGE.

IF WE ARE MEETING IN PERSON, YOU CAN FILL THESE OUT AT THE OFFICE IMMEDIATELY BEFORE YOUR APPOINTMENT OR YOU CAN COMPLETE THEM AHEAD OF TIME AND BRING THEM WITH YOU OR EMAIL THEM TO ME


 

IF WE ARE MEETING VIA VIDEO OR PHONE, PLEASE FILL OUT THE FORMS AND EMAIL ALL PAGES TO ME AT

COASTALCOUNSELINGANDCONSULTING@GMAIL.COM


 

INITIAL INFORMATION

INFORMED CONSENT TO TREAT

1632 N Coast Hwy, Newport, OR

(Sea Towne Shopping Center - 2nd Floor)

541.819.2121

 Thursdays & Fridays

Appointment Times: 1230 until 630pm

If you are in the mental health field and like the style of my website, I'd be happy to help you create your own professional website.  Please give me a call at 541.819.2121 and we can talk about details.