Forms – Womencare

Welcome to Womencare

Please click on the links below to access the necessary forms for your first visit. Please print, complete the forms, and bring them in with you to your first session.

We look forward to working with you.

Counseling Forms

1. Client Information Form

2. Intake Paperwork

3. Intake Paperwork (En Español)

4. HIPAA Notice

5. Debit/ Credit Card Authorization Form

6. No Surprises Act Information

7. Good Faith Estimate

Additional Forms

1. Release of Information

2. Group Counseling Agreement

3. Professional Consultation Agreement