• WELCOME
  • ABOUT ME
  • MY PRACTICE
    • Individual Therapy
    • Couples Therapy
    • Sex Therapy
    • Out-of-Control Sexual Behavior
        (a.k.a. "Sex Addiction")
    • Sexual Acting-Out (Adolescents)
  • TELETHERAPY
  • LET'S GET STARTED
    • What to Expect
    • Rates and Insurance
    • Forms
  • CONTACT ME
  • MY BLOG

 

 

If you are a new client, please print out and complete the applicable forms and bring them with you to our first appointment.

If you are a new client interested in engaging in Teletherapy, please complete the applicable forms and email them to Dagmara Svetcov, LMFT prior to your first appointment.

 

 

Individuals (Adults)

Client Intake Form
Acknowledgement of Receipt
Informed Consent (Adults)
Teletherapy Informed Consent (Teletherapy Clients Only)
Notice of Privacy Practices (Read Only)
Emergency Procedures (Read Only)

 

Individuals (Minors)

Client Intake
Acknowledgement of Receipt
Informed Consent (Minors)
Teletherapy Informed Consent (Teletherapy Clients Only)
Notice of Privacy Practices (Read Only)
Emergency Procedures (Read Only)

 

Couples

Client Intake
Acknowledgement of Receipt
Informed Consent (Couples)
No Secrets Policy
Teletherapy Informed Consent (Teletherapy Clients Only)
Notice of Privacy Practices (Read Only)
Emergency Procedures (Read Only)

 

Optional

Authorization to Release and Exchange Confidential Information
Permission to Digitally Record Therapy Sessions

 

Dagmara Svetcov, LMFT     P 972.793.8488     F 844.726.0543     Email