Therapy Client Forms

For Therapy Forms we use a secure, HIPAA Approved service so you can be assured your data is safe. Please use the links below to send us an email requesting the form, we will send you the links to the secure forms to your email, please add the Form Title(s) to the email.

If you have any questions please contact us at alleybreezewellness@gmail.com

Therapy Intake Form

Informed Consent for Teletherapy & Online Therapy

Policies & Procedures Form

Release of Information Form

Credit Card Authorization Form