Without Hope There is No Help
Auburn Remote Hippa Compliant Remote Therapy - Teletherapy
The program we use is called Vsee, it is HIPPA compliant and all information is secure and will not be saved other than in your client file as a record of the service provided.
Phone: (253) 333-2328
Fax:  (253) 333-5068
Address: 230 Auburn Way S. Suite 1B
Auburn, WA. 98002

Mental Health Intake Form

Please answer the Mental Health Intake Form below. Alternatively you can download the form here.
If you haven't already done so, please also fill out the insurance form here.

These forms must be filled out prior to your initial consultation.

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    • 01 - Basics
    • 02 - Suicide Risk Assessment
    • 03 - Past Medical History pt.1
    • 04 - Past Medical History pt.2
    • 05 - Past Psychiatric History pt.1
    • 06 - Past Psychiatric History pt.2
    • 07 - Past Psychiatric History pt.3
    • 08 - Exercise Level & Substance Use
    • 09 - Tobacco History
    • 10 - Family Background & Childhood History
    • 11 - Trauma, Educational, & Occupational History
    • 12 - Family & Personal History


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(253) 333-2328
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Auburn, WA