INTAKE FORMS

Counseling Forms

Please click each form to print and fill out before your first session.

Individual Intake Form – one per person
Fee Agreement
Disclosure Statement
Notice of Privacy Practices

Jessa Zimmerman

FORMS FOR ONLINE COUNSELING

Online Counseling Forms

Forms should be mailed to Jessa Zimmerman, 1904 Third Ave, Suite 622, Seattle, WA 98101 prior to your first session.

Individual Intake Form – one per person
Notice of Privacy Practices
Online Therapy Fee Agreement
Online Therapy Disclosure Statement

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