San Diego Individual Therapy

​

Cognitive Behavioral Therapy for Emotional Wellness, Social Skills, and Personal Growth.

​

ROBYN COUGHLIN, LCSW

LCS#24137 

 

​Phone: ​619-997-5310​​​​​​

Please read & complete appropriate forms prior to first appointment. 

INTAKE FORMS

​​

​

  • New Client Form

 

  • Child Information Form



  • Teen Information Form​​​

  • Adult Information Form

CONSENT FORMS

​​

​

  • Consent for Treatment​​​

 

  • Consent to Treat a Minor



  • Notice of Privacy Practice​​​



  • Receipt of Privacy Practice​



  • Accounting of Disclosures



  • HIPAA Authorization Form

​

  • Release of Information

 

  • About

  • Services

  • Intake Forms

  • Rates & Insurance

  • Contact

  • More

    Use tab to navigate through the menu items.

    Robyn Coughlin, LCSW   619-997-5310                                                                                                                                                8690 Aero Drive STE: 115-219, San Diego, CA 92123