Christina Mason Counseling

Client Forms

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New client forms

Please complete the forms that apply to you before your first session. Each opens securely in Carepatron and takes just a few minutes.

Adult Intake Questionnaire

Background information to prepare for your first adult session.

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Child Intake Questionnaire

Background information for a child or adolescent client.

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Informed Consent

Review and acknowledge the terms of our therapeutic relationship.

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Consent for Treatment of a Minor

Required consent for clients under 18.

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HIPAA Notice of Privacy Practices

How your health information is used and protected.

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Insurance Release of Information

Authorize release of information to your insurance provider. For Aetna and Sendero clients.

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Credit Card Authorization

Securely authorize payment for sessions.

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Other Insurance

How to seek reimbursement from other insurance companies.

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