Required Forms
- Client Intake Form
- Limits of Confidentiality/Life Coaching Cancellation Policy
- 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:
- Authorization to Disclose Information Form
If you’re a new client, please complete the following forms and bring them to your first session. Please note that while there may be terminology that appears on forms or materials and even enters into discussions that includes the word(s) “psychotherapy”. “therapist”, “therapy”, “mental health professional”; please understand clearly that for the purpose of the relationship with Linzi Levinson in connection to any business services being offered here through this Life Coaching practice, I am claiming to be working only in the capacity of a Life Coach. While therapeutic issues may be come up or be discussed in sessions; if you feel you are in urgent need of clinical psychotherapy, or feel you are at risk for mental health issues that are compromising your health, safety and wellness, it is best you look into clinical psychotherapy counseling immediately. I would be glad to assist you with referrals to accomodate and meet your needs now or should this need arise, and truly hope that you would allow me to do so. Please ALSO print out the CLIENT DISCLAIMER FORM which is listed separate from this page, and read and sign it prior to session. If you have any questions, feel free to bring your questions so that we can discuss them and make sure you are comfortable with anything that you sign.
