Client Forms
Complete your paperwork securely online. All forms are encrypted and stored confidentially.
Intake FormRequired
Share information about yourself, your background, and what brings you to therapy. This helps us prepare for your first session.
Informed ConsentRequired
Review and agree to the terms of your therapeutic services, including fees, confidentiality, and your rights as a client.
HIPAA AuthorizationRequired
Authorize how your protected health information may be used and disclosed in accordance with federal and Florida law.
Release of InformationOptional
Optional — authorize Peaceful Connections to share or receive information with a school, medical provider, or other party.
Your privacy is our priority. All forms are protected under HIPAA and Florida law. For questions, contact us at (813) 602-1892.