Sample Forms

Intake form:

Click to access information_to_share_with_the_therapist.pdf

Informed Participation Agreement:

Click to access mental_health_and_substance_use_informed_participation_agreement__-_inner_annealing_psychotherapy_llc.pdf

Privacy Practices:

Click to access notice_of_privacy_practices_.pdf

Relevant Laws:

Click to access laws_for_your_information_and_your_protection.pdf

Resources

Crisis Services

• Suicide and Crisis Lifeline:
  • call or text 988

• Crisis Text Line:
  • text TALK to 741741

• Dane County 24 Hour Mental Health Crisis Line:
  • call 608 280-2600

• 24 Hour LGBTQ Youth Crisis Hotline (Trevor Lifeline):
  • call 1-866-488-7386 or text START to 678-678

• Emergency Services:
  • call 911