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Welcome! We're so happy you found us :) If you're ready to take that first step, just fill out this form and we'll get started...

New Client Intake Form

Client's Date of Birth
How would you like to be contacted?
I'm looking for....
I would like...
What qualities do you look for in a therapist? Choose as many as apply:
Are you a veteran or an active member of the military?
Yes
No
Do you have a history within the last 6 months of suicide attempt?
Yes
No
Are you currently involved in any legal disputes?
Yes
No
Are you currently in a household that is experiencing domestic violence?
Yes
No
Who referred you to Key Therapy?
I'm a returning client
Google
Psychology Today
Friend/Family/Neighbor
School Counselor
Facebook Group
My doctor/therapist/health provider
I was referred by someone who is currently a client of Key Therapy
My insurance company
Other

Please note: Key Therapy is not able to offer 24/7 crisis services. If you are in crisis, please call 211. If you are having a mental health emergency, call 911 or go to your nearest ER.

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