+1 360-626-1457
17183 Clear Creek Rd NW, Poulsbo WA 98370-7225


Questions or concerns not addressed here? Complete the contact form below or call 360-626-1457.

Client Information & Forms

[The copyrighted forms and documents in this section are for client use only and may not be reproduced without permission of the author.]

New Client Packet

Documents to be read and agreed-upon at–or prior to–your first session are located in Step 2 on the Appointments page.

NOTE: If you would prefer not to submit the fillable forms (over the Internet through secure, encrypted email directly to our office) before your first session, you may also print and fax or mail the completed forms to us.  As another alternative, you may print out these documents, read the notices and disclosures, and bring the completed forms with you to your first session.   If you have any difficulty submitting these required forms, please call us at 360-626-1457.

Signed forms are required of all adults and teens who are participants at any time during a counseling session.

Stop Smoking Flier

Print this page out for yourself or someone you love.

Our highly successful smoking (& chewing) cessation program utilizing clinical hypnosis can quickly and effectively stop the addiction once and for all. Use this flier for yourself, to post in your workplace, or as a gift certificate for a friend or loved one. Put our 30 years of experience to the test.

Authorization For Release of Confidential Information

Standard release we must receive before providing confidential information to others.

The law requires that you complete and sign a release form if you wish us to send information about you to third parties including health providers and anyone else.

EMDR Brochure

Introductory brochure about this treatment.

Eye Movement Desensitization and Reprocessing is one of the biggest breakthroughs in mental health over the past thirty years. We are proud to offer this specialized work.

EMDR Preparation

Exercises you must complete prior to treatment.

This is a detailed description of the three exercises we ask that you complete if this treatment is recommended for you and you choose to engage in the process.


Frequently Asked Questions About

Face-to-Face Counseling

  • How do I find the right counselor?
  • How do I/we get started?
  • What happens in the beginning sessions?
  • What is the cost of sessions under my Employee Assistance Program (EAP) ?
  • What is the cost of sessions under my health insurance?
  • When is payment due, and what forms of payment do you accept ?
  • In which insurance and EAP plans do you participate?
  • Do you take clients without insurance or those who do not wish to utilize their insurance?

Frequently Asked Questions About

Video & Telephonic Counseling 

  • Is there a difference between telehealth and telemedicine?
  • How does telehealth work?
  • Will my insurance cover telehealth?
  • How can I access telehealth care as a client?
  • Is telehealth safe for me and my family?
  • Can telehealth be used for couples and other relationship counseling?

Directions to Our Office

17183 Clear Creek Rd. NW, Poulsbo, WA 98370-7225

Click here for Location Map and Directions (You can zoom out to see access routes from all areas.)

Contact Us

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