Teresa Utley, M.S. Marriage and Family Therapy Associate 
Helping to build your "TREE OF LIFE"
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FORMS


To save time you may download the forms to your computer, fill out the paperwork prior to your session. Read all the disclaimer and HIPPA paperwork. Bring any questions to the session regarding the paperwork.

Utley Practice and Disclaimer Form (Read and sign signature page for first appointment)

HIPPA Form (Read and sign signature page for first appointment)

Email or Text Reminder Form (Optional)

Authorization to Use or Disclose Information (Use if you want your information shared with your physician/other)

First Appointment Orientation

 Client Initial Information Sheet (Read and sign signature page for first appointment)