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
2. Client Information Form (Download)*
4. Notice of Privacy Practices
5. Receipt of Privacy Practice Notice
6. Consent for Telehealth Counseling or Consultation
7. Informed Consent for Covid In-Person Appointments
8. Debit/Credit Card Authorization Form (Download)*
9. No Surprises Act Information
10. Good Faith Estimate (Download blank form)*
Additional Forms
1. Release of Information (Download)*
3. Professional Consultation Agreement
*Download forms are enabled so that you can type your responses directly on the forms to email back or print out to bring to your session.