Client Forms

If you are a new client of Debbie Cohen, MA please be sure to download and fill out the following forms. Then, bring your filled out forms with you to your first meeting/session. This will help ease you into therapy, and allow as much time to be spent on you, as possible.

Client Contact Information Sheet

Client Intake

Authorization for Release of Information

Limits of Confidentiality

Start a telemedicine call with

DebCohen

Telemedicine by

Doxy.me

Send a Message

Your Name*

Email*

Phone*
Your Message
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Yes, I want to submit this form
By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

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