If you feel your life is in immediate danger please call 911 or visit your nearest emergency room.
Suicide Hotline: Dial 988
Little Lamp Christian Counseling LLC
Intake Forms
The following paperwork, "Policies and Consents" and "Intake Demographic", must be reviewed and completed, and signed prior to your first appointment. I will address any questions or concerns you may have pertaining to this paperwork during your first session. Please use a computer as phone completion is not supported.
Clicking on the title will bring up a PDF form that can be completed in browser, on the computer, or printed.
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Completing in the web browser: You can fill in the boxes in your web browser, then click on "download". A drop-down will appear with 2 options: "With my changes" or "Without my changes". Choose to download the document with your changes and save it to your computer. During your first session I will direct you to upload your completed documents to Doxy.me for my retrieval.
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Completing on the computer: You can download the document (without changes) and complete the form on your computer, outside of a web browser. To do this, you will need software that can open a PDF file such as Adobe or PDFgear. Once completed, save it to your computer and during your first session I will direct you to upload your completed documents to Doxy.me for my retrieval.
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Completing on paper: You may choose to print the documents, fill them out on paper, then scan the completed forms onto your computer (or take high quality photos of the completed documents and transfer those photos to your computer), and save it to your computer. During your first session I will direct you to upload your completed documents to Doxy.me for my retrieval.
Note: Your "Electronic Signature" does not need to be cursive, or fancy font; it can be typed just like everything else.
Important Information
The following documents, including the Notice of Privacy Practices, do not require completion or signatures; however, please review them so you are familiar with all the information provided.
