Arizona Center for Counseling and Psychotherapy/Zoe Folts, LCSW Therapy for Individuals, Couples, & Families

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Arizona Center for Counseling & Psychotherapy
Zoë Folts, L.C.S.W.

602-697-0453
PO Box 6937
Chandler, Arizona 85226

 
zoe@zoefolts.com
 
New Patient Forms

There will be 10 minutes set aside during the first session to fill out paperwork and other administrative tasks.  If you complete the forms I have included here on my website and bring them in with you to your first session, the process will go much quicker.  There are a few other forms you will need to sign when you come in that are not on our website including :

1.  Consent for Treatment form (clarifying expectations of our counseling relationship)
2.  HIPPA policies for our office. 
3.  Release of Information (if needed)
4.  Consent for treatment of a minor (if needed)

You will receive a copy of our HIPAA  (Health Insurance Portability and Accountability Act)  policies as well as our offices policies. HIPAA is a federal law protecting your health information (Protected Health Information).  The Notice of Privacy Practices describes how we protect your PHI in accordance with applicable laws and the NASW Code of Ethics.

I have included 2 forms here on the website that will make the process faster.  If you are a new client, please complete the following forms and bring them to your first therapy session.  If you are a couple coming in together, if you would each fill out these forms individually, that would help me get to know each of you. 

Client Psychotherapy Intake Form 

Life History Questionnaire

 I look forward to meeting you in person.


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