Forms

Ronald A. Alexander, PhD

Licensed Marriage, Family, and Child Therapist

License Number MFC#7707

 

Patients and clients who have an appointment with Dr. Alexander are required to complete and sign an electronic online form before their first session. Below are links to HIPAA-compliant forms for Psychotherapy Patients, Emotional Wellness Clients, Group Therapy / Coaching Clients, and Individual Coaching Clients.

Please complete and electronically sign the forms that apply to you. Once you click “Submit” at the bottom of the form, it will be automatically sent to us.

Individual, Couple, and Family Psychotherapy for California Patients

If you live in California, complete and sign the New Patient Intake Form and the Client Information Form.

 

Emotional Wellness Forms for Clients Outside of California

If you live outside of California, complete and sign the Emotional Wellness Intake Form and the Client Information Form.

 

Group Therapy & Group Coaching Forms

If you are participating in either In-Person Group Therapy or Virtual Group Coaching, please complete and sign the Group Therapy & Group Coaching Intake Form and the Client Information Form.

 

New Client Coaching Forms

If Dr. Alexander is coaching you on a one-on-one basis, please complete and sign the New Coaching Client Intake Form and the Client Information Form.

 
If you have any problems or questions, please email Rhonda at virtual.rhonda@hotmail.com or call 818/515-5105.