Portland Wellbeing

Helping you to create balance in your life.

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Download Forms

Here you can download intake, consent, and authorization forms in PDF format. In order to view these PDF files, you must have a PDF reader program installed. If you do not already have such a reader, you can download a free reader at Adobe’s website.

Counseling Forms

  • Authorization for Treatment
  • Notice of Privacy Practices
  • Adult Intake
  • Adolescent Intake Evaluation
  • Child Intake
  • Consent to release information

Coaching Forms

  • Coaching Forms

Coaching Forms

In order to view these PDF files, you must have a PDF reader program installed. If you do not already have such a reader, you can download a free reader at Adobe’s website.

  • Coaching Forms

Counseling Forms

In order to view these PDF files, you must have a PDF reader program installed. If you do not already have such a reader, you can download a free reader at Adobe’s website.

  • Authorization for Treatment
  • Notice of Privacy Practices
  • Adult Intake
  • Adolescent Intake Evaluation
  • Child Intake
  • Consent to release information

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Copyright 2015 Lisa M. Loewenthal, LCSW - All Rights Reserved | Site Map | Tech Support