New Patient Form

If you are a new patient looking for treatment, please fill out this form and I will contact you for additional information and appointment scheduling.

*

arrow&v
arrow&v
arrow&v
arrow&v
arrow&v

New Patient Paperwork (PDF-518kb)

Please print, complete and bring

to your first appointment

Download the Free AdobeReader®

This site and the materials and information contained in it have been prepared for informational purposes only. Neither your use of this information nor your submission of the new patient form creates a counselor/patient relationship. A relationship with Katie Freeman, LCSW is only created by signing a written patient agreement. Any and all information received by email that does not result in a written patient agreement is discarded.

BSM_BSWords.png