Olive Tree Counseling

Forms

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Download the corresponding forms via the links below and email them to [email protected] **Please Note: All paperwork must be submitted the day before your first appointment to avoid rescheduling. OTC cannot legally see clients without the necessary authorization.
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Adult

ADULTS: Intake Packet
File Size: 573 kb
File Type: pdf
Download File

Minor

MINORS: Intake Packet
File Size: 526 kb
File Type: pdf
Download File


Policies & Privacy

Please keep a copy of all privacy and policy forms for your personal records.
Online Communications Consent
File Size: 238 kb
File Type: pdf
Download File

Privacy Policy
File Size: 145 kb
File Type: pdf
Download File

Rates & Payment
File Size: 154 kb
File Type: pdf
Download File

Request for Therapy Form
File Size: 155 kb
File Type: pdf
Download File

Please read all Release of Information forms carefully.
Release of Information: ADULTS
File Size: 215 kb
File Type: pdf
Download File

Release of Information: MINORS
File Size: 216 kb
File Type: pdf
Download File


Where applicable
Update Client Information
File Size: 46 kb
File Type: pdf
Download File

Unlicensed Therapist Agreement
File Size: 193 kb
File Type: pdf
Download File

Checklist of Concerns
File Size: 201 kb
File Type: pdf
Download File

child_checklist_of_characteristics.pdf
File Size: 156 kb
File Type: pdf
Download File


Therapist Disclosure Statements

Brittney Punt, Disclosure Statement
File Size: 159 kb
File Type: pdf
Download File

Holly Hoff, Disclosure Statement
File Size: 115 kb
File Type: pdf
Download File

Kenneth Brewington, Disclosure Statement
File Size: 96 kb
File Type: pdf
Download File

Keri Chandler, Disclosure Statement
File Size: 65 kb
File Type: pdf
Download File

Picture
Phone: (907) 357-6513
Fax: (907) 357-6514
1981 E Palmer-Wasilla Hwy, Ste 220
Wasilla, AK 99654
If you are having an emergency, please call 911 or the suicide hotline at 988 immediately.
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