Client Forms

New clients will need to fill out forms before services can begin. To make the process as smooth and efficient as possible, Meredith Furr provides access to forms on this website. Alternatively, you may arrive 15 minutes early to your first appointment to complete appropriate paperwork.

Please complete the appropriate intake form (child, college age, or adult), the business policy, and consent to exchange information form. To complete the forms, select the appropriate download link, print the form, complete it by hand, and bring the forms in person to your first appointment or email if you have a telehealth appointment.

Business Policy

Please download, print, and bring the business policy to your first appointment.

Informed Consent

Please download, print and bring the informed consent to your first appointment.

Child and Adolescent Intake

This form is for patients ages elementary through high school.

Adult Intake

This form is for adult patients.

Financial Responsibility

This form is to be completed when the patient is not responsible for their therapy bills and a third party (e.g., parent of an adult patient, extended family member, etc) will be paying for treatment.

Credit Card Authorization

Complete this form to put a credit card on file to facilitate payment for therapy. This is especially helpful when a teenage patient drives themselves to therapy but their parents pay for services.

COVID-19 Policy

This form is necessary for any in-person counseling while Covid-19 protocols are in place.

Insurance Information

Please download and bring this form to your first appointment if you have Blue Cross and Blue Shield Insurance.