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Helpful Forms

If you're a first-time client, please review and complete the following forms, bring them to your first session

Client Intake Form (for clients over 18)

Permission to Treat Minor (for children only)

HIPAA Policy Concerning Text and Email Messages

Acknowledgement of HIPAA Policy

Credit Care Authorization

Teletherapy

The following is for review purposes only

HIPAA General Policy

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

Authorization for the Release of Healthcare Records

Note: To download Adobe Acrobat Reader for free, click here .

Contact JM Counseling

Location

Availability

Appointments Available Online For All Residents of Florida

Monday:

12:00 pm-8:00 pm

Tuesday:

Closed

Wednesday:

12:00 pm-8:00 pm

Thursday:

Closed

Friday:

12:00 pm-8:00 pm

Saturday:

Closed

Sunday:

Closed