Cynthia Roberts, MS, LPC
FOR LIFE'S MOST IMPORTANT RELATIONSHIPS

Required Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

Individual, Adult and Couples Intake Form



Child and Teen Intake Form



Pregnancy and Postpartum Intake Form


Limits of Confidentiality/Therapy Cancellation Policy




If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:



Authorization to Disclose Information Form





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