I look forward to meeting with you very soon. Please complete the forms below and email them back to me prior to the first session. 

PAYMENT: Payment is expected prior to our first session and will be thereafter charged on the day we meet. Please submit a payment in the amount your counselor specifies. The fee for reserving your appointment with me are considered due 24 hours prior to your appointment time. Cancellations prior to this 24-hour-before-your-session point incur no charge. 

The following forms are REQUIRED for meeting with Keith Miller:

Client Data Form and Consent for Care – Keith Miller

Client-Clinican-Agreement-Form-Keith-Miller

 

The following forms are OPTIONAL and used only when needed

Consent for Release of Information