Mary Sims Gerdes, MA, LPC, NCC

Counseling for adults, couples, and parents in Phoenix

Forms for First Appointment

Your first appointment is called an "Intake Appointment." I ask each new client to complete these forms. To save time, please download these forms, read them carefully, sign where indicated, and bring the completed forms with you to your first appointment.

The Intake Forms

Client Information Form (PDF)

Informed Consent for Counseling Clients: Rights, Responsibilities, and Limitations (PDF)

HIPAA Notice of Privacy Practices (PDF)

If more than one person will be participating in the counseling sessions, both people will need to complete their own set of forms.

If you have questions, you can call me at 480-444-8723, or you will have the opportunity to ask questions when we meet.


From time to time, I write articles that address the different issues that affect my clients. Please feel free to read my latest article!

Three Communication Strategies That Can Improve Your Relationship TODAY! (PDF)