Tessa Suppes Forms
I look forward to meeting with you very soon. Please complete the forms and bring them to the first session or you can take the first few minutes of your session to fill them out after I greet you in the waiting area.
NOTE ABOUT PAYMENT: Payment is expected at each session. Checks or cash are preferred. Please make checks payable to “Keith Miller Counseling, LLC.” We also accept Visa, MasterCard, and Discover (see credit card form below).
The following two forms are REQUIRED for new clients meeting with Tessa Suppes:
Tessa Suppes Client-Clinician Agreement & Authorization for Care Form
Tessa Suppes Client Data Form
The following forms are OPTIONAL and used only when needed:
CREDIT_CARD_AUTHORIZATION_FOR_SERVICES_FORM
Consent for Release of Information
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