Required Forms

New Client Intake Form
Please complete a separate form for each person that will be meeting with Don Baker, MA, LMHC.

Disclosure & Consent for Services
Please complete a separate form for each person that will be meeting with Don Baker, MA, LMHC.

HIPAA Notice and Receipt
Please provide signatures for each person that will be meeting with Don Baker, MA, LMHC.

Insurance and Credit Card Consent
Please fill out this form completely and notify Don Baker, MA, LMHC if/when any of this information changes.

Optional Form

Release of Information
Authorization for release of information to specified parties (i.e physicians, spouses, etc.)