New Attachment Client Intake Forms

Welcome to The Attach Place Forms Page

These are our intake forms. Bring them with you to the first session.  If you are confused by something on a form, just skip that question and we can figure it out together when you get here. Thank you.

All New Attach Place Clients Complete These Forms. Click Here.

Click here to complete The Attach Place New Client Intake Form.

Click here to complete The Attach Place Medical/Psychiatric History Form.

Additional Required Assessments for Attachment Therapy ONLY. Click Here.

Additional Required Assessments for NeuroDevelopmental Movements Therapy ONLY. Click Here.

Additional Required Forms for Neurofeedback ONLY. Click Here.

For Consulting with Other People or Professionals:

By completing these Release of Information Form you will be allowing The Attach Place clinicians, Ce Eshelman, LMFT, Jen Nguyen LMFT, Teri Gelgood, LMFT, and Alcira Ascencio, LMFT to contact other people or professionals for the purpose of continuity of care.