Cristina Lima Therapy

Psychotherapy / Neurotherapy

 

Forms
 
If you are a new client please review the following documents before your first therapy session.

 

Clinical Policies. Read this form to learn about the clinical policies at Cristina Lima Therapy. Contact me if you have questions.

 

Notice of Privacy Practices. Read this form to learn more about federal and local laws regarding confidentiality.

 

If you are a new client you also need to complete the following forms.
 
The following forms are fillable forms that you can complete in your computer. Please complete the form, print, and bring to your first session.
 
(If it does not open automatically in the fillable format, try a different browser. Google Chrome works best. If you are using Mozilla/Firefox, please download the document by clicking on the icon located on the top right side, and save it. The downloaded document should be fillable.)

 

Informed Consent. This form is your consent to therapy. Please complete with your personal information, print, and sign. Before you sign this form, make sure you read the Clinical Policies and the Notice of Privacy Practices. Please bring the signed form to your first appointment.

 

Intake Form. This is the intake form for individual therapy. Complete, print and bring to your first appointment. (Your confidentiality is important to me. If you want to send the intake by email, contact me at 281-770-1779 for instructions.)

 

Authorization for Release of Information. This is an optional form. If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, school counselor, etc.), you will need to complete this form to authorize release of information.

 

If neurotherapy is an option for you, please review the additional documents bellow.

 

Consent for Neurotherapy. This form is your consent to neurofeedback treatment. Please complete, print, and sign it. Make sure you read the document Neurotherapy Information before you sign.

 

Neurotherapy Information. Please read this document to learn more about neurotherapy before you sign your consent for neurofeedback treatment.

 

 

Note: You will need Adobe Acrobat Reader to be able to access the forms in your computer. To download Adobe Acrobat Reader for free, click here.

Contact

Cristina Lima

PhD, LPC, LMFT, BCN

 

1523 Ravenel Ln

Sugar Land, TX 77479

Tel: 281-770-1779

 

cristinalima@

cristinalimatherapy.com