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BELOW ARE THE proper forms (highlighted in blue,) you will need to complete and bring with you to your first visit.


1. In Balance Studio Child & Teen Intake Information Form

This form gives me detailed information about your child or teen. Please complete in full and bring with you.

2. In Balance Studio Informed Consent

Informed consent gives you important information about In Balance Studio’s professional and business policies & practices.  

You do not need to print the whole document.  Instead, both parents (or legal guardians) must sign Page 9.  Signatures are required before your child’s first appointment.  

If one parent has sole legal custody, only one signature is required and a copy of the custody agreement must be presented at first session and kept on file.

3. In Balance Studio Consent to Disclose Protected Health Information (PHI)

By signing this form, you are agreeing to In Balance Studio’s Notice of Privacy Practices outlined in the below two documents. Please take time to read either the BRIEF or FULL version before signing this document.

4. In Balance Studio Release of Information

If you would like your child’s care to be coordinated with his/her pediatrician, physician, psychiatrist, school counselor, teacher, pastor, or another professional, you will need to complete this Release of Information form prior to or at your child’s first visit. 

5. Animal Assisted Play Therapy:  Informed Consent & Release of Liability Form

This form gives you important information regarding working with animals in play therapy, including the risks and benefits.  Please read carefully and sign.