Created by Dave Boyer 12/2013Vestibulum | Sed vulputate

Dave Boyer, M.Ed, CADC1, LMFT

390 W 12th Ave., Suite 201

Eugene, OR 97401

Phone (541) 344-7088

Fax (888) 990-2234

Intake Forms & Questionnaires

Client Information FormProfesssional Disclosure StatementPatient Health QuestionnaiirePTSD Checklist

The buttons below open client information & history forms, HIPAA disclosure and consent to treatment forms, 2 short screening questionnaires, communication policies, and my Professional Disclosure Statement.  

Please review these forms, then print and complete the Client Information Form, Client History Form, Patient Health Questionnaire, PTSD Checklist (optional), and HIPAA Consent Form prior to your initial session so that we can take more time to get to know one another and discuss your concerns.

HIPAA Disclosure (Full Version) HIPAA Disclosure (Short Version) HIPAA Consent Form Communication Policy Client History Form