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For New and Returning Clients

Intake Form for Therapeutic Coaching 

with Amber St. Germain and Play Therapy

After you have had a phone consultation with me, please fill out the Intake Form, the Liability Waiver and the Payment Info Form. I must have all 3 forms filled out at least 24 hrs in advance in order to hold the day and time of our appointment. Thank you for your time and attention to these legal logistic requirements. The forms can be completed in less than 15 mins. 

You can also scan the QR code to get to the Payment Info Form. 

 

I appreciate your trust in sharing sensitive and vulnerable information with me. Rest assured, I am completely committed to safeguarding your privacy, confidentiality, and overall safety. 

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