Michael Blair
435-703-0756
PO Box 650158
Sterling, Utah 84643
blaircounseling@gmail.com
HELPFUL FORMS

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Psychotherapy Intake Form...Please note our 24 hour cancellation policy...we will work with you and your insurance company as much as possible and there will be a copay in most cases...filling these out ahead of our meeting maximizes our therapy focus immediately...Thanks.
  • Please only fill out the LIfeStar registration form if you are in fact registering for our LifeStar Phase I, II or III classes.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form  

 

 

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