^M Intake Forms – Jim Reavis, LCSW

Intake Forms


Before your first appointment, you can get a head start by downloading and completing the forms listed here. It will maximize our time together and provide the important information I need to begin counseling with you. If you are coming for marital or relationship counseling, be sure to complete a form for each person.  If it is inconvenient to download these forms, let me know before the appointment and I will provide these for you when you come to meet with me.

Client Information

Individual Intake Evaluation

Couples Intake Evaluation (Complete 2)

Consent to Treatment (Sign)

Notice of Privacy Practices (For your information only)

Privacy Policy Acknowledgement (Sign)

Credit Card Authorization (optional)