Forms

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Intake Form

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Credit Card Authorization Form

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Release of Information Form

(Please print, fill it out and bring it in to your first session)

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Consent for Treatment Form

(Please print, read carefully, sign and bring to the first session with you)

Forms

Contact

Laura L. Darke Ph.D.

Clinical Psychologist

Home

Background

(Print and sign only if you feel that it is important for me to communicate with any person or professional in your life)

(Please print, fill out and bring to first session. If you prefer to pay by check, then please bring a check to each session)