Intake Forms

NEW CLIENT PAPERWORK

For
Amie Lowery-Luyties, MFT

cool red arrowStep 1: Print Out The Forms Below
cool red arrowStep 2: Read And Sign The Forms
cool red arrowStep 3: FAX them to: 888-746-6008  OR  Mail Them To:

Amie Lowery-Luyties
PO Box 15450
Long Beach, CA 90815

New Client Intake Forms >>>

Intake Forms (For All New Clients)

Online Therapy Consent Form(Online Therapy Clients Only)


 

The sooner you mail in the signed forms, the sooner we can begin therapy!

SEO Powered by Platinum SEO from Techblissonline