

therapy 4kidz,inc
therapy 4kidz,inc
Child and Adolescent Therapy/Family Therapy

New Client
New clients are asked to print out a registration packet. This packet includes two documents for you to read: the Client Agreement and the Notification of Privacy Practices. It also contains two forms for you to print out, complete, and bring to our first meeting: the Signature Form and the Client Information Form. Please also print out and complete the Child Clinical Assessment Packet. Completing this paperwork in advance will allow us to focus immediately on how I can provide help when we first meet.

New Clinical Assessment --CHILD.doc (DOC — 67 KB)

Clinical Assessment for 18 and up.doc (DOC — 157 KB)

Release of Information for therapy4kidz.inc.docx(DOCX - 23 KB)
Therapy 4Kidz, Inc/Christine Pierozzi-Matusek, LCSW
129 Haven Street, Suite D1
Hendersonville, TN.37075
615-513-7151
Note: All clinical information and urgent needs should not be emailed. Please call 911 in an emergency or go to the nearest emergency room.