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  • Home
  • About
    • Valerie Fahie
      MA, LPC
    • Mary Kate Brosnan
      MA, R-DMT, CYT-200
  • Services
    • Cognitive Behavioral Therapy
    • Counseling for Anxiety
    • Grief & Bereavement Counseling
    • Group Therapy
    • Individual Therapy
    • Mindfulness Based Therapists
    • Therapy for Depression
    • Walk & Talk Therapy
    • Supervision Services
  • Getting Started
    • FAQs
    • Rates and Insurance
    • Client Forms
    • Appointment Request
  • Resources
    • Mental Health Links
    • Physical Health Links
  • Contact
  • Blog
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Valerie Fahie 267-755-8633
Mary Kate Brosnan 267-907-2429
107 North Broad Street
Office #308
Doylestown, PA 18901

 

Close menu
  • Home
  • About
    • Valerie Fahie
      MA, LPC
    • Mary Kate Brosnan
      MA, R-DMT, CYT-200
  • Services
    • Cognitive Behavioral Therapy
    • Counseling for Anxiety
    • Grief & Bereavement Counseling
    • Group Therapy
    • Individual Therapy
    • Mindfulness Based Therapists
    • Therapy for Depression
    • Walk & Talk Therapy
    • Supervision Services
  • Getting Started
    • FAQs
    • Rates and Insurance
    • Client Forms
    • Appointment Request
  • Resources
    • Mental Health Links
    • Physical Health Links
  • Contact
  • Blog
  • Instagram
267-755-8633

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Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

  • Client Intake Form
  • Information Sheet
  • Limits of Confidentiality
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Fee Payment Agreement and Medical Billing Release
  • Statement of Informed Consent
  • Authorization for Emergency Contact
  • Credit / Debit Card Payment Consent

Let’s Walk It Out

  • Statement of Informed Consent
  • Medical Clearance

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

Contact Today

107 North Broad Street
Office #308
Doylestown, PA 18901

267-755-8633

267-907-2429

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Contact Information

107 North Broad Street
Office #308
Doylestown, PA 18901

267-755-8633
267-907-2429

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