Forms

 

New Client Forms

Please complete these 3 and bring or email prior to your first visit.

New Client Intake Form

Office Policies & Procedures

Consent for Services

 

Drug & Alcohol Evaluation Forms

SALCE Pre- Evaluation Sheets

 

Gender Therapy Forms

Letter for Surgical Corrective Surgery:  M to F

Letter for Top Surgery & Consent: F to M

Letter for Hormones – (Consent Form)

Letter Request – (Required for all letters)

Gender History

Gender ASSET – (to be completed prior to surgery)

Family Comments – Child and Adolescent History

Gender Glossary

 

Additional Forms

Authorization for the Release of Confidential Information

Letter Request – (Required in All Letters)

Enneagram

Insurance Information Form

Family of Origin History

 

    Contact me at 713-524-9525 or fill out the form below. I welcome your call so we can discuss your specific situation and the benefits therapy may provide for you.



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