Carol Montgomery Brosnac, MA, LMFT - Transgender & Gender Diverse Psychotherapy
Intake/Assessment Forms(Includes Informed Consent, HIPAA Info, and Payment Information)

(Fill out if you would like any of your private health information shared with anyone else, such as doctors, attorneys, family members, etc.)

("Stuff About Me" If you are between 12-19, please fill out this form and submit it with your Intake/Assessment Forms)

(Specify which group and complete it and submit with your Intake/Assessment Forms)

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