Forms
New Patient Forms
connect with Beverly
Pre-Counseling Profile
Fill this out before your first appointment to better acquaint me to your background and situation. Click to download PDF.
Client Agreement
This is our agreement. Privacy, confidentiality, etc. Required to proceed with a session. Click to download PDF.
Tele Mental Health Informed Consent
For us to meet online, certain protocols must be followed. Fill this online informed consent to proceed with our sessions.
When forms are completed, please scan or send forms back to beverly@beverlymerriam.com.