Counseling, Psychotherapy, Clinical Supervision, and Consultation, Syracuse NY Paul F. Pickett, Ph.D., L.M.H.C.

  • Home
  • Psychotherapy Philosophy
  • Types of Counseling Provided
  • Clinical Supervision For Clinicians
  • Help for the Helping Professional
  • Help in Difficult Economic Times
  • Individual Consultation
  • Business Consultation
  • Common Questions
  • Patient Forms
  • Rates & Insurance
  • Links
  • About Me
  • Contact Me
Paul F., Pickett, Ph.D., L.M.H.C.
(315) 701-5850
528 Oak Street
Syracuse, New York 13203
docpic@twcny.rr.com
Patient Forms

If you're a first-time client, please review and complete the following forms, bring them to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form
  • Professional Disclosure Statement/ Informed Consent Form 

 

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

  • Consent to Release Information Form

 

 

Confidentiality and cancellation policy  
Client intake form  
Professional Disclosure/Informed Consent Form  
Authorization for Release of Information  

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


©2012 by TherapySites.com. All rights reserved.
3fc3c63ff30a999d089abb4ca7be5d28