Intake Forms

Intake Forms


If you’re a new patient, please complete the following appointment forms and bring them to your first therapy session. These intake forms will speed up the intake process and provide more time to talk.


If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Note: To download Adobe Acrobat Reader for free, click here.








Intake Forms, Privacy, Lou Carfizzi, Depression, Family Counseling, Couples Counseling, Marriage and Family Counseling, 123 Tribble Gap Road, Cumming, Ga., Dawsonville, Ga., Psychotherapy, Therapy, Therapy in Cumming Ga., Georgia, Christian Counseling, Professional Counseling, Abuse Victims, Sexual Victims, Insurance, Blue Cross Blue Shield, Aetna, Cigna, Medicaid, Wellcare, Amerigroup, Faith Based, Non-denominational. Therapist, Therapy, Counseling, Counselor, Psychotherapy, Psychotherapist, Marriage Counseling, Family Counseling, Family Therapy, Couples Counseling, Mental Health Care, Couples Therapy, Depression, Anxiety, Relationship Counseling, Marriage and Family Therapy, Therapists, Counselors, Mental Health Counselor, Christian Counseling, Christian, Teen Counseling, Grief Counseling, Christian Marriage Counseling,Addictions Counseling, Career Counseling,Couples Therapy, Liberty University, Phd Professional Counseling, Specialist Degree, Georgia State university

2 comments on “Intake Forms”

  1. Karen Tellez Reply

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