New Client Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.
Client Intake Form
File Size: 52 kb
File Type: pdf
Download File
Limits of Confidentiality/Cancellations
File Size: 71 kb
File Type: pdf
Download File

Current Client Forms

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Authorization to Disclose
File Size: 2382 kb
File Type: pdf
Download File
Note: To download Adobe Acrobat Reader for free, click here.
Stages Of Life Counseling Inc
23133 Hawthorne Boulevard
Suite 207
Torrance, CA 90505

(310) 502-0164
Click Here to Email Us​​​