INTAKE FORMS to Be Completed Prior to Treatment


Identify the service you are seeking to determine the correct forms to print and complete prior to your first appointment.

2. Child or Teen for Individual Therapy


  • New Client Form

  • Child or Teen Information Form 

  • Consent to Treat a Minor

  • Receipt for Privacy Practice

  • HIPAA Authorization Form (Optional)

  • Release of Information (Optional)

4. Mindfulness Skills Group


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