Ptsd Management Therapy Consent Form
Please complete this form to confirm your intake and acknowledge the expectations and consent for PTSD management therapy.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Communication
Email
Phone Call
Text Message
Have you previously participated in therapy for PTSD?
Yes
No
What are your main goals for PTSD management therapy?
Treatment Expectations
Signature (Please sign to acknowledge your consent and understanding of therapy expectations)
*
Submit
Submit
Should be Empty: