Aimée Lim-Miller, LICSW
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Forms

If you're a new client, it is helpful to get background information to better understand your situation.  Please complete the following forms and bring them to your first consultation session.  Please note that these forms may take some time to fill out.   If you are unable to print these forms, I will have them ready for you to fill out during our first meeting.  Please arrive early so you may review them while in the waiting room.   Any questions regarding these forms may be addressed during our session.
INTAKE FORM
File Size: 196 kb
File Type: pdf
Download File

AUTHORIZATION FORM
File Size: 275 kb
File Type: pdf
Download File

SERVICE AGREEMENT
File Size: 108 kb
File Type: pdf
Download File

DISCLOSURE FORM
File Size: 62 kb
File Type: pdf
Download File

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.
  • Home
  • About
  • Common Questions
    • Privacy & Policies
    • TeleTherapy
    • Rates, Insurance, Payment >
      • Invoice Payment
    • Forms
  • Contact Me
  • Resources
    • Attachment Work
    • CBT Worksheets
    • Mindfulness & Self-Compassion >
      • Mediation Samples
      • Progressive Muscle Relaxation
      • Visualization/ Guided Imagery
    • Assessment Tools
    • Anxiety/ Panic Disorder >
      • ACT- Thought Defusion
      • Brain & Nervous System
    • IFS
    • Relationships & Intimacy
    • Race, Culture, Ethnic Identity Development >
      • BIPOC Support
    • GLBTQQI
    • VALUES WORK
    • EFT
    • Trauma >
      • Window of Tolerance
    • COVID-19