CLIENT ASSESSMENT FORM

Please fill out this form prior to coming for your first session.

  • Contact Details

  • Someone who could be called if you needed support after a session. Please include full name and phone number.
  • Medical History

  • General Health

  • Session Details

  • All sessions are confidential however as part of their training, our therapists are required to video record sessions. After being viewed by a supervisor, the video is deleted. At your initial session you will be asked to sign a consent form that outlines the details of this.