Deborah L. Smith Counseling
Deborah L. Smith Ed.M/LMHC
(13 years and over)
(12 years and younger)
We understand that this is a lot of paperwork. Please allow yourself, spouse, or child enough time to complete the forms recommended for them. Each form has a purpose and will allow the therapist to help diagnose and treat the client. If there are questions about any of the forms please do not hesitate to contact our office.
Please complete the forms and bring them to the initial appointment. If you would like to attach them to an email,
please send the completed forms to email@example.com. If you choose to submit forms via email please fill out our email authorization form listed below under "Other Forms."
You have the option of printing the forms and handwriting the information in the required spaces. If you are unable to open the forms, you can pick them up at our office during hours of operation, Monday - Friday 9:00am-5:00pm.
If you have questions on how to print the forms, please visit our "FAQ's" page.
Please Note: If you arrive to your appointment at the time it is scheduled and your paperwork is not completed, we will have to re-schedule your appointment.
We look forward to working with you and your family.
Choose this form if you would like to transfer your records from our office to another provider or if you would like our office to be able to obtain records from a previous provider.
Choose this form if you would like to obtain a copy of your own records or the records of
your child. Please remember that if your child is currently over the age of 13 they must
sign the form. Please also keep in mind that there is a charge for this service.
Choose this form if any of your information has changed.
Choose this form if you are going to attach any forms to an email or need to email for any reason.