Kim Kelly Counseling
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Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.
  • Client Psychotherapy Intake Form
  • ​Counseling Policies 

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

Note: To download Adobe Acrobat Reader for free, click here.

CONTACT

Kim Kelly Counseling
  (760) 420-5439
  333 S. Juniper, Suite 115
Escondido, CA 92025
US
 kim@kimkellycounseling.com
Contact Me

SCHEDULE APPOINTMENT

Start your new path in life and be the change today!
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helpful forms

View and print forms for your appointment.
CLICK HERE

© Copyright 2016 Kim Kelly Counseling.

  • Home
  • Services Provided
    • Rates & Insurance
  • Common Questions
    • Links & Resources
    • Hot Topics!
    • Privacy & Policy
  • Appointment Request
    • Helpful Forms
  • Contact Me