Policies and Forms

Calabasas Counseling Center forms and policiesCalabasas Counseling Center provides licensed therapy and educational consulting services for the purpose of improving the quality of life and relationships in our clients.  With these types of services, several forms may be required regarding the legal protection of your privacy, office policies, an agreement for services to be provided, as well as a consent for treatment form – a separate form  each  for children and adults.

Please discuss your situation with our office regarding the correct selection of the necessary forms for your or your family member(s).  Each of the forms that may be required are listed below, including download links for printing and signing the documents upon your first visit.

Please be sure to read our office policies and privacy statement carefully before signing the forms.

Office Policies:

  1. Office Policies
  2. Privacy Statement

 

Forms:

  1. Agreement for Psychotherapy Services
  2. Consent for Treatment
  3. Consent for Treatment of a Minor
  4. Authorization to Release Information

 

Melissa Mose, MFT

Contact me

Melissa Mose, MFT
23622 Calabasas Road
Suite 104
Calabasas, CA 91302
(818) 222-6340
melissamose@gmail.com

Melissa provides individual therapy, couples counseling, teen groups and family therapy for the greater San Fernando Valley area, including Calabasas, Woodland Hills, Hidden Hills, Tarzana, Encino, Agoura, Westlake Village, and Malibu.