Client Forms

Our intake packet and additional forms are now available online! You can electronically sign our forms without having to print them out - cutting down your wait time for your first session! If you have questions about these standard forms, please contact our office for additional information. 

New Adult Client Packet

This packet is for new clients aged 14 and older. NM law states that individuals age 14 and older can consent for their own treatment. If someone other than the client is covering the cost of services, please have them complete a credit card authorization form as well.

Master Level Clinician Consent

If your assigned therapist is a Master Level clinician, they receive direct supervision under A New Hope Therapy Center Clinical Supervisor, Jessica Cauthorne, LCSW. Your assigned therapist received their Master’s degree in a clinical field and is receiving supervision to obtain their independent license.

New Child Client Packet

This packet is appropriate for individuals under the age of 14 and should be completed by their legal guardian. 

*If there is joint custody, each parent/guardian need to complete a packet for their child.

Intern Level Clinician Consent

If your assigned therapist is a Clinical Intern , they receive direct supervision under A New Hope Therapy Center Intern Supervisor, Eric Gomez, LMFT. Your assigned therapist is receiving their Master’s degree in a clinical field and is providing clinical hours with our group. 

Credit Card Authorization

An additional authorization form should the cost of services be covered by someone other than the client. All packets include this form, this is an additional one to be used as needed. 

Electing to Self Pay

A New Hope Therapy Center accepts many of the major insurance plans for our area. There are many reasons why you may opt to not use your insurance coverage. If we accept your insurance plan, but you would rather not use them, please complete this form.