New Client Intake Form

Welcome to The Attach Place Forms Page

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

For All New Therapy Clients:

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

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

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, and Alcira Ascencio, LMFT to contact other people or professionals for the purpose of continuity of care.