Intake Forms

NEW CLIENT PAPERWORK

For
Amie Lowery-Luyties, MFT

Step 1: Print Out The Forms Below

Step 2: Read And Sign The Forms

Step 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 Form (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!

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