MK Counseling Services
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Printable Forms

New Client Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.
Client Intake Form
File Size: 75 kb
File Type: pdf
Download File

Limits of Confidentiality/Cancellations
File Size: 71 kb
File Type: pdf
Download File

Current Client Forms

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Authorization to Disclose
File Size: 2382 kb
File Type: pdf
Download File

Note: To download Adobe Acrobat Reader for free, click here.
Contact Me
135 Cumberland Rd.
Ste. 102
Pittsburgh, PA 15237

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MK Counseling Services
135 Cumberland Rd
Suite 102
​Pittsburgh, PA 15237

(412) 999-2244

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  • Blog
    • Contact >
      • Book Appointment >
        • Rates
  • Home
    • About The Practice >
      • About The Counselors
      • Privacy Policy
      • What To Expect
  • Therapy Specialties
  • Eating Disorders
    • Anorexia & Bulimia
  • Resources
    • Coping Skills >
      • Self-Harming
      • Chronic Impulsivity
      • Somatic Complaints >
        • Grief Counseling
      • Helpful Links
      • Anger Management
    • Common Questions
  • Blog
    • Contact >
      • Book Appointment >
        • Rates