Client Forms

If you are new, please download and print these forms before our first session. These forms can also be filled out during the first session if you don’t have the ability to print.

Intake Form

Release of Information Form

Privacy and HIPAA

 


 

START THE HEALING

Don’t let another day go by! If you live in northern Colorado (Fort Collins, Greeley, Windsor, Loveland), call to make an appointment today. I’ll return your call within 24 hours.

Contact Today



Windsor, CO

info@mendingheartscounseling.com

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Please note:
This is an unsecured message/non-HIPAA compliant.
By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.