Once your appointment is secured, you will be sent a secure link to complete the intake forms and consents. Please have this filled out prior to your intake appointment.  The link will come from admin@juliasocounseling.com email, so please check spam if you don't see it. If there are any custody legal arrangements, we will need a copy of those court documents (if applicable) sent to admin@juliascounseling.com.  If you have a custody agreement, we must have a copy of this on file prior to seeing your child. ​

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If you would like your therapist to coordinate care with another provider at any point during therapy (i.e,, psychiatrist, physician, other family member, step-parent, etc.), complete this form to authorize release of psychotherapy information:

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• Consent to Communicate (minor)

• Consent to Communicate (adult)

 

Communication and Privacy Policies/Terms and Conditions

Julia's Counseling and Play Therapy Group respects your privacy. By opting into our SMS messaging service, you agree to the following terms regarding how we handle your data:

Data Collection: We will collect your name, email address, mailing address, and mobile phone number when you sign up for SMS updates. The information will be collected via the website contact form, or the intake packet upon becoming a client.
Data Usage: We use your data solely for sending administrative related questions regarding scheduling and or billing.
Data Security: We protect your data with secure storage measures to prevent unauthorized access. Data Retention: We retain your information as long as you subscribed to our SMS service. You may request deletion at any time.

Message Frequency: Julia's Counseling and Play Therapy Group will text you in response to any questions or inquiries you text from 832-303-8933. With the consent box checked on the home page here of the opt in message, we will reply to your online inquiry. 
MESSAGES AND DATA RATES MAY APPLY: Your mobile carrier may charge fees for sending or receiving text messages, especially if you do not have an unlimited texting or data plan.
Contact Julia Cedeno at 832-303-8933 or admin@juliascounseling.com for HELP or to STOP receiving messages.
Opt-Out: You can opt out of the SMS list at anytime by texting, emailing, or replying STOP or UNSUBSCRIBE to admin@juliascounseling.com or 832-303-8933. After unsubscribing, you will receive a final SMS to confirm you have unsubscribed and we will remove your number from our list within 24 hours.
You can send HELP for additional assistance, and you will receive a text including our Phone number, email and website. We are here to help you.
Non-Sharing Clause: We do not share your data with third parties for marketing purposes. Julia's Counseling and Play Therapy Group will not sell, rent, or share the collected mobile numbers.

You may also click here to Read the Notice of Privacy Practices

Confidentiality & Privacy Policy

The law protects the relationship between a client and a therapist, and information cannot be disclosed without written permission.

Exceptions include:

• Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.

• If a client is threatening serious bodily harm to another person/s, I must notify the mental health authorities and/or law enforcement.

• If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.

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