Intake Forms


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!

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