LPC Client Intake Form
2367 Tacoma Ave. S. - Tacoma, WA 98402 / Email: shawnberthel@lifepathcounseling.com / O: 360-865-4852

Welcome to Life Path Counseling!

The information you are being asked to complete now will provide me with some important details about you, your life, and your current situation. Additional documents (to be completed later) will also give you some details about the policies and procedures of this practice. Some of the forms included are a Professional Disclosure Document (required by law); and if desired, a Services and Payment Plan Contract to help with paying for your sessions. Please note that if you elect not to sign up for the payment plan contract, you will be required to pay for your services in full when billed or rendered. Otherwise, you will need to set up a payment plan. If you are a member of a participating referral service program, the terms and conditions for the rate of your session (as well as any policies of the practice), will apply. Further information can be obtained by a discussion with me directly.

I want to thank you for your time and attention in completing this packet. I am honored to provide what I hope will be a worthwhile, safe, and professional counseling experience. Your feelings and issues are important to me, so the more details I have about you as you begin the counseling process by completing the intake form, the better I can help you.

I look forward to working with you.

Shawn Thomas Berthel, M.S., LCMHC

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