New Client Intake Forms
Complete your intake forms online before your first appointment at Therapy SRQ
Welcome to Therapy SRQ! We are glad you are taking this important step toward supporting your child’s, teen’s, or young adult’s mental health. To make your first appointment as smooth as possible, please complete the appropriate intake form below before your visit.
Child & Teen Intake Forms (Ages 3–17)
For children and adolescents, a parent or legal guardian must complete the intake form. This form covers your child’s developmental history, current concerns, family background, and insurance information. Completing it before your appointment allows our therapist to prepare and make the most of your first session.
Young Adult & Adult Intake Forms (Ages 18+)
Young adults and adult clients can complete their own intake form. This form covers your current concerns, mental health history, medical background, and insurance details. All information is confidential and protected under HIPAA.
What to Expect at Your First Appointment
Your first session is an opportunity for you and your therapist to get to know each other. During the initial appointment, Christine Murawski, M.A., LMHC will review the information from your intake form, discuss your concerns in more detail, answer your questions about the therapy process, and begin developing a personalized treatment plan. First sessions typically last 50 to 60 minutes.
What to Bring
Please bring the following to your first appointment: a valid photo ID, any relevant school or medical records, and a list of current medications. If your child is the client, both the child and the parent or guardian completing the intake form should attend the first session.
Office Policies
Cancellations: We ask for at least 24 hours notice if you need to cancel or reschedule your appointment. Late cancellations and no-shows may be subject to a fee.
Confidentiality: All therapy sessions and records are strictly confidential and protected under Florida state law and federal HIPAA regulations. Information is only shared with your written consent, except in situations involving safety concerns as required by law.
Payment: Payment is due at the time of service.
Questions Before Your First Visit?
If you have questions about the intake process, your first appointment, or our services, please don’t hesitate to reach out.