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About Me
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John Lumiere Wins
About Me
My Offerings
Articles
John Lumiere Wins
About Me
My Offerings
Articles

Forms

New? Please complete the following forms and email them to johnis1ofus@gmail.com before your first session.

Client Psychotherapy Intake Form

Limits of Confidentiality/Therapy Cancellation Policy

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 Information

Note: To download Adobe Acrobat Reader for free, Click here.

Grass Valley, CA 95945
(510) 301-8578
johnis1ofus@gmail.com

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