Helpful Forms

Ed DeBellis, Psychologist - Counseling, Anxiety, Psychotherapy, Relationships - Barrington, IL, Palatine, Crystal Lake, Algonquin

If you're a first-time client, please review and complete the following forms, bring them to your first session. This is optional and designed to free up time in our first visit.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

  • Consent to Release Information Form
Client Intake Form
Confidentiality and Cancellation Policy
Consent to Release

Note: To download Adobe Acrobat Reader for free, click here .

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Helpful Forms

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