FORMS
I. PRE TREATMENT: Print, read, and bring these at your first Intake session (or email them)
- Psychologist-Client Service Agreement
- Adult Intake Form
- Child & Adolescent Intake Form
- Consent to Collect Personal Information
- Consent to Treatment
- Consent to Disclose Personal Health Information (Dr. Gina to professional)
- Consent to Disclose Personal Health Information (Professional to Dr. Gina)
- Welcome New Clients please read. Thanks!
II. TREATMENT:
SURVEYS
I have created this page with the goal of asking you for your feedback. I want to continue tailoring all my products and services to meet YOUR needs. So I’ve created simple surveys to give you the opportunity to tell me what you think. This should take no longer than five minutes to complete and the information will help me serve you, and individuals like you, even better.
Thanks so much and I look forward to read your feedback.
Dr. Gina Madrigrano
If you are a parent, caregiver or teacher, complete survey now.
You can also recommend products or services that you would like me to create or recommend. Thanks in advance for your precious feedback.