Client Forms

If you have arranged an appointment with one of our therapists, our intake forms are located here. Your therapist will require them before a first visit. If you are meeting in the office, he or she will have forms on hand as well. If you prefer to fill them out at that time, please arrive to your appointment 15 minutes early. Please let your provider know if you have any questions or concerns.

Required forms:

Client Information Form

Emergency Contacts Form

Informed Consent Form

Optional forms:

Release of Information Form (only needed if you want your provider to speak with anyone else on your behalf, such as a physician or school counselor- can be completed later if a need arises)

Credit Card Authorization Form (if you want to keep a card on file to pay session fees)

DrJesseMatthewsSesameIntakePacket7-2021 (ONLY FOR CLIENTS USING SESAME)

Matthews Counseling / 145 Little Conestoga Road Chester Springs, PA 19425