Intake Forms

MENDING THE PIECES OF YOUR LIFE...

Client Forms

In an effort to provide quality time together during your first session, please complete the following forms within 48 hours of your appointment. All forms are HIPAA compliant and your privacy is protected and secured through the TheraNest Client Portal.

New Clients

New clients must complete intake forms 48 hours before their first session

New Client Intake

Existing Clients

Existing clients can utilize the portal to send HIPAA compliant emails to your therapist. If you have seen a therapist here before you do not need to fill out new intake forms unless your therapist asks you to.

Existing Client Portal

*Notice: The Texas Behavioral Health Executive Council (TBHEC) investigates and prosecutes professional misconduct committed by marriage and family therapists, professional counselors, psychologists, psychological associates, social workers and licensed specialists in school psychology.

Although not every complaint against or dispute with a licensee involves professional misconduct, the Executive Council will provide you with information about how to file a complaint.

Please call 18008213205 for more information; address: 333 Guadalupe St., Tower 3, Room 900, Austin, TX 78701.

Client Forms

New Clients

New clients must complete intake forms 48 hours before their first session

Existing Clients

Existing clients can utilize the portal to send HIPAA compliant emails to your therapist. *If you have seen a therapist here before you do not need to fill out new intake forms unless your therapist asks you to.*

© 2014 Mending Broken Pieces

Existing clients can utilize the portal to send HIPAA compliant emails to your therapist. If you have seen a therapist here before you do not need to fill out new intake forms unless your therapist asks you to.