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John Fitzgerald, PhD, LPC, CAS

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Forms

New Client

Before our first session, please download, complete, and email back the following two forms. If you don’t have a scanner, just take a picture of the forms with your phone and email them to me as pictures.

New Client Enrollment Form

Professional Disclosure Statement Form

Evaluation

Depending on your needs, I may suggest you complete a Behavioral Health Evaluation. This form evaluates many aspects of your life, and includes a number of validated assessment measures that can offer valuable insights into the nature of your life challenges. Remember that all your answers are covered by our confidentiality agreement, so be as truthful as you can when completing the form.

Behavioral Health Evaluation Form

 

 

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Contact Information

John Fitzgerald, PhD, LPC, CAS
503.343.5666
drjohnfitz@gmail.com

Copyright  ©2023

 

Resources

  • About Me
  • Forms
  • Fees
  • FAQ

Services

  • Teletherapy
  • Consultation
  • Home
  • About
    • My Background
    • My Approach
  • Services
    • Teletherapy
    • Consultation
    • Fees
    • Forms
  • Blog
  • FAQ
  • Contact