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 two electronic online forms 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, please complete and sign the following two forms:

New Patient Intake Form

Client Information Form

Emotional Wellness Forms for Clients Outside of California

If you live outside of California, pleasae complete and sign the following two forms:

Emotional Wellness Intake Form

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 following two forms:

Group Therapy & Group Coaching Intake Form

Client Information Form

New Client Coaching Forms

If Dr. Alexander is coaching you on a one-on-one basis, please complete and sign the following two forms:

New Coaching Client Intake Form

Client Information Form

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