For child under the age of 18:
| Child History Form | Child Rating Scales |
| Consent to Release to Insurance Co. | Email and Phone Information |
| Please select the informed consent form for the therapist you are seeing: | |
| Mary Mikalson, MSSW | Mindy Haseleu, Psy.D. |
| Tanya Green, MSW, LCSW | Levy O'Brion, MS, LPC |
For an adult:
| Adult History Form | Adult Rating Scales |
| Consent to Release to Insurance Co. | Email and Phone Information |
| Please select the informed consent form for the therapist you are seeing: | |
| Mary Mikalson, MSSW | Mindy Haseleu, Psy.D. |
| Tanya Green, MSW, LCSW | Levy O'Brion, MS, LPC |