Client Forms

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

Client Intake Form

Client Information Sheet

Limits of Confidentiality/Therapy Cancellation Policy

Authorization for Use or Disclosure of Protected Health Information



10906 Sheldon Rd.
Tampa, FL 33626
&
Psychiatric and Psychological Services:
1211 N. Westshore Blvd. Suite 100, Tampa, FL 33607

davelapens@aol.com
Phone: (978) 407-3291
Fax: (813) 281-2474

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