CALL (732) 741-1333 | Barbara Fane, LCSW, BCD, Monmouth County Therapy & Counseling - 23 White Street, Shrewsbury, NJ 07702

New Client Forms

If you are a new client, please complete the following forms and bring them to your first therapy session:

» Client Psychotherapy Intake Form [PDF]

» Limits of Confidentiality/Therapy Cancellation Policy [PDF]

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 [PDF]