Appointment Request
If you’re a new client, please complete the following forms and bring them to your first therapy session.
Intake Paperwork [Click Here]If you would like Mary Beth to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information.
Consent for Release of Confidential InfoNote: To download Adobe Acrobat Reader for free, click here.
Prior to your first appointment:
Please download and complete the forms available on the website. The information you provide will allow Mary Beth to assist you as efficiently as possible. They contain valuable information about the office and policies. Filling the paperwork out ahead of time will give you an opportunity to take your time. If you have any questions you can address them at your first appointment.
On your appointment day:
Please bring the printed and signed forms with you. Mary Beth will be looking forward to meeting you.
When you Arrive:
As you come into Interlachen Village Plaza, make a right and proceed to the side of the building that has a row of trees. Park under the shade of the trees and look for our sign: Counseling, Testing, and Tutoring. Mary Beth’s name and phone number are by the door.