Amy Sander Montanez

M.Ed., D.Min., LMFT, LPC, Life Coach

Forms

Individual Therapy

Each client must complete the individual intake form before beginning therapy.

EACH client must complete this form. There are 12 pages, so please give yourself plenty of time.

Individual Client Information includes:

  1. Client Intake (4 pgs)
  2. General Information and Consent for Therapy (2 pgs)
  3. Policy, Fees, Payment, Insurance, & Scheduling (1 pg)
  4. General Consent for Communication Guidelines (2 pgs)
  5. General Consent for Telemental Health Communication (1 pg)
  6. No Surprises Act (1 pg)
  7. Notice of Privacy Practices (HIPAA) (1 pg)

Download Individual Form

Couple's Therapy

Couples complete individual forms plus the couple client information form.

Couples should complete the Individual Client Information Forms AND the Couple Client Information form. There are 19 pages, so please give yourself plenty of time.

  1. Individual Client Information (12 pgs)
  2. WTCC Couple Client Information (7 pgs)

Download Couple's Form

Coaching

Coaching client information form.

Coaching Client Info

Download Coaching Form