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    873 West Baxter Drive | South Jordan, UT 84095
    admin@reachcounselingutah.com | voice: (801) 446-3515
    text: (925) 876-4282
    fax: (801) 601-1578

  • Reach Counseling

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    Client Forms

    If you are new to the working with me, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

    Adult History Form

    Child History Form

    Client Information

    HIPAA Notice of Privacy Practices

    Informed Consent for Treatment

    Reach Counseling – General Saftey Plan

    Reach Electronic Payment Authorization

    Reach Practice Policies, 2020

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

    Release of Health Information

    COVID 19 Release & Agreement

     

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    873 West Baxter Drive South Jordan, UT 84095

    (801) 446-3515 admin@reachcounselingutah.com

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    Reach Counseling
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