Center for Healing & Personal Growth

drronitfarzam@gmail.com (310) 991-9616 (310) 902-0990 (310) 773-9196

Forms

We take pride in respecting your time and investment in therapy. We prefer to spend your appointment time getting to know you instead of filling out paperwork. For that reason, we ask that you please complete the following forms prior to your arrival. If you are unable to do so, please arrive 15 minutes prior to your appointment, and advise your counselor so they may have the forms ready for you to fill out in our waiting room.

For couples and family therapy, please complete the adult intake form and the consent forms for each person.

  • Minor Intake Form: [ Download ]
  • Adult Intake Form: [Download ]
  • Doctor’s Lien Form: [Download ]
  • Adult Personal History: [ PDF ]
  • Minor Personal History: [ PDF ]
Latrauma Therapists

How I Feel When I Hear NO

By Ronit Farzam
Illustrated by Bonnie Lui
Publication date: March 2024