loader

Forms

Current & Perspective Clients

Please go to your Simple Practice Client Portal to access documents.

Forms should be completed no later than 3 days after scheduling your session. 

Your client portal will have any forms you need to complete before your first session. You will have other forms or assessments requested throughout the therapy process to monitor your symptoms.

  • You are able to request your sessions from the Simple Practice site. Your appointment is secured when you receive a confirmation. Please complete forms once confirmation is received.
  • We will go over any questions you have about the forms during your first session. You can also email me prior to the session with any questions or concerns. 
  •  The first session will be a getting-to-know-you time, that includes the initial assessment period and discussion of what you’d like to work on in therapy.  

Information provided on all forms is used to learn about your history, stressors, goals for therapy, and current situation that may require addressing immediately. 

Forms are sent and completed in the Simple Practice Portal. 

Please complete at least 3 days prior to your session.

Intake Therapy Form

Sexual Health Intake Form

Release of Information

Consents

 

Mood and Symptom Assessments

Emergency Contact Sheet

Good Faith Estimate

Reach Out To Me At:

(408) 763-9546 

Email: CherisseGage@

BreatheAgainTherapy.com

A Transgender, Gender Identity, Gender Expression, & Sex Worker Affirmative Therapist.

Online Therapy Available
Looking forward to Supporting your goals
Business Hours

8:00 am – 6:00 pm (Monday)

9:00 am – 1:00 pm (Tuesday)

8:00 am – 12:00 pm (Thursday)

 
 

Copyright @ 2022 Breathe Again Therapy