Helpful Forms

New patient registration forms will typically be sent as a part of the confirmation email for the initial appointment.  However, if you did not receive these forms or just need to access them again they are all available on this page for download.  New patients are required to complete the Polices & Procedures , Privacy Policy & Consent for Treatment , Background & History , and MPaCT Screening Questionnaire forms before treatment can begin.  Additional forms are also available below.


New Patient Forms

Policies & Procedures
Privacy Policy & Consent for Treatment
Background & History
MPaCT Screening Questionnaire (Online Form)


Additional Forms

Authorization to Release Mental Health Information
Credit Card on File Policy
Late Cancel & Missed Appointments Policy
Review of Systems
Wellness Checklist
MPaCT Screening Questionnaire (Printed Form)

 

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Helpful Forms

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Family Therapy Clinic of Louisiana, LLC
225) 292-0155
(844) 715-7911 fax
[email protected]