Dr. Bergin Family Counseling Services

Forms for Your Visit

OfficeIn the interests of saving you time, we ask that you download our new client forms and fill them out prior to your first visit. 

  • Click on each form requested

  • Print the form out

  • Fill the form or forms out completely

  • Call our office for any clarifications you may need

  • Bring the  forms with you when you visit Dr. Bergin Family Counseling Services

 

                    
Assignment of Benefits                        

                    
Authorization

                    
Hippa / Client Authorization of Privacy Rights

                    Confidentiality Statement

                    
Guidelines and Policies

                    
Informed Consent

                    New Client Form