Helpful Forms

WELCOME!  If you're a new client,  please fill out all forms listed on this page with the exception of The Insurance Verification Form and email to me at least 48 hrs prior to your initial session, or print all forms, fill them out and bring them to your initial consultation.  Please contact my biller in order to fill out the Insurance Verification Form with her.   Her information is listed on the New Patient Information tab. Thank you

PDF Client Intake Form

PDF Client Confidentiality Form

PDF Cancellation Policy

PDF Counseling Contract

PDF Patient Info Sheet

PDF Patient Info Update Sheet
This form is to be used for the continuing treatment for individuals that I am currently treating. This is used to verify your ongoing insurance: only used in the month of January for the new year. 

PDF  New Patient Insurance Verification Form
Only use this form if your have not contacted my biller and left all ins info with her or in a message

 Telehealth Consent Form
Only complete this form if our sessions are using the computer or phone
PDF Secondary Insurance Form
(only complete this form if you have secondary insurance)

PDF HIPAA Authorization
ONLY complete this form if you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.) to authorize a release of your psychotherapy information.

Note: To download Adobe Acrobat Reader for free, click here .

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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Links & Resources

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Helpful Forms

Click here to view and print forms for your appointment.

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Lynda Green-Alter, LMFT
949 453-9600
4 Venture, Ste. 230
Irvine, CA 92618

[email protected] : website