At Horizons, the well-being of our clients is our highest priority

 login

Horizons Forms - click to view/download

Adult Intake Form

Couple Intake Form

Child/Teen Intake Form

Release of Information Form

HIPAA Notice of Privacy Policies and Practices

At Horizons, we use a packet of intake forms to gather information and to clarify procedures before we see you for the first time. You may fill out the forms at the office (please come 15 - 20 minutes early to do so) or you may print out the forms at your leisure, fill them out at home and bring them with you.

If the client (the person in whose name services will be billed and perhaps insurance billing submitted) is an adult coming for an individual appointment, click here to download, view and print out an intake form.

For couples, click here to download, view and print out an intake form. The person in whose name services will be billed should complete pages 1-7.  The spouse/partner should complete pages 8-9 and also sign pages 6-7. 

If the client (the person in whose name services will be billed and perhaps insurance billing submitted) is under 18, click here to download, view and print out an intake form.

Insurance companies often have negotiated rates with Horizons or with individual therapists. At times, therapists make arrangements with clients for reduced fees. Your fee agreement will reflect agreements with your insurance provider or made directly by you with your therapist.