Peace River Psychology Center
Patient Forms

Please download and fill out these forms before your first visit.  fill out forms

You will need to complete a few forms before we see you for the first time. These forms are available for download below, or you are welcome to arrive 15 - 20 minutes prior to your first appointment to complete the forms in the office. If you have not been to our offices before, or are not certain where the office is, please leave yourself extra time before your initial appointment in case you have trouble locating the office.

You can see a map to each of our offices on the Contact Page.

When the appointment begins, there is no pressure on you to know where to start or what to talk about. We will help guide you through the session. However, it can be helpful for you to consider what you want us to know about your current struggles, areas of your life or your past that would help us understand you better as a person, and goals that you have for therapy (i.e., if therapy were ultimately helpful, what would be different for you?).

Click on each form, download to your computer, then print and fill out
these forms, and bring them with you for your first appointment:


pdf logo PRPC Consent Form
Informed Consent for Treatment and Financial Agreement.


pdf logo PRPC New Patient Information Form
Questions about the patient.


pdf logo PRPC Patient Health Questionaire
Questions about your health.


pdf logo PRPC HIPAA Privacy Notice
Notice Regarding your Right to Privacy.

We treat children, adults, and everything in between.

We help you deal with:

  • Anger management
  • Affairs
  • Alcohol problems
  • Anxiety
  • Bariatric evaluations
  • Caregiver stress
  • Chronic health conditions
  • College adjustment
  • Communication skills
  • Dementia
  • Depression
  • Divorce
  • Family conflict
  • Family issues
  • Grief and loss
  • Health-related stress
  • Identity issues
  • Issues in aging
  • LGBT issues
  • Life transitions
  • Loneliness
  • Marriage problems
  • Men's issues
  • Midlife crisis
  • Memory impairment
  • Mood disorders
  • OCD
  • Parenting issues
  • Personal growth
  • Problems at school
  • Pre-marital counseling
  • PTSD
  • Relationships
  • Retirement
  • Self-esteem
  • Sexual abuse
  • Sexual identity
  • Spiritual issues
  • Stress and anxiety
  • Substance abuse
  • Terminal illnesses
  • Weight management
  • Women's issues
  • Work/life balance