972-523-2958

-- dr. crystal robinson psy. d., lmft --

Licensed Marriage and Family Therapist #202919

 

Intake Form

Hope is Within Reach

To help expedite the check-in process, please download, print  and complete the intake forms prior to your first appointment. Please do not return forms via email.

Thank you!

(Please click on “+” to right of form for additional direction and download link.)

Informed Consent

Please complete this form for each adult that will participate in therapy.

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Adult Intake Form

Please complete one of these forms for each adult that will participate in therapy.

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HIPPA Form

Please complete for each adult that will participate in therapy.

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Consent To Treat A Minor

Please complete this form for each minor that will participate in therapy (must be completed by at least one parent or legal guardian).

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Child/Minor Intake Form

Please complete this form for each minor that will participate in therapy.

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Release of Information Form

Please complete this form for each adult or minor only if you would like for Dr. Robinson to mutually communicate some or all of your information about treatment with another entity such as an agency, a past therapist, or hospital, a doctor, employer, school teacher, etc.

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Treating
Couples and Families

Treating
Individuals

Where to Find Dr. Robinson

Dr. Crystal Robinson

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