Pacific Counseling Partners of Hawaii, LLC
  • Home
  • About Me
  • Insurance and Rates
  • Contact and Location
  • First Visit Forms

First Visit Forms

Please print, review and complete the forms below, and bring them to your first visit.  Initial session is one hour.  Subsequent sessions are typically 50 minutes.

If the primary patient is a minor (under age 18), please complete the Child/Adolescent Individual Form and bring it to your first visit.  Please note that the legal parent or guardian of the minor will need to sign the consent forms.

Informed Consent.pdf
File Size: 164 kb
File Type: pdf
Download File

Registration Form.pdf
File Size: 46 kb
File Type: pdf
Download File

Intake Information.pdf
File Size: 95 kb
File Type: pdf
Download File

Child Adolescent Individual Form.pdf
File Size: 69 kb
File Type: pdf
Download File

HIPAA.pdf
File Size: 194 kb
File Type: pdf
Download File

HIPAA Acknowledgement Form.pdf
File Size: 25 kb
File Type: pdf
Download File

Powered by Create your own unique website with customizable templates.