FORMS TO REVIEW BEFORE OUR FIRST APPOINTMENT
Great things start with a single step
Please review the forms below before your first appointment so you can become familiar with my office policies. I am happy to discuss any questions you might have before we meet or during our meeting(s).
Filling them out ahead of our first session will allow us to make full use of our initial session.
- Client Data Form
- Client Therapist Agreement
- HIPPA Privacy Information Form
- Authorization for the Release of Information
NEW! In this current Covid-19 pandemic, I am fully equipped to bring my services to you via teletherapy, or distance therapy. Here’s the form:
I am looking forward to working together.
At the conclusion of, or during our work together you could help me learn what you think I am doing well and what could use improvement. Please fill out and return this Client Satisfaction Survey to me.
Get in touch.
I'm always happy to hear from people.
If you have any questions, need more information, or would like to make an appointment, you can call me at 301-279-7779, email me at [email protected], or use the form below.
Licensed Clinical Social Worker • Over 15 years of experience • Certified Emotionally Focused Couple Therapist and Supervisor • Member of The Greater Washington Society of Clinical Social Work • Member of the International Centre for Excellence in Emotionally Focused Therapy • Member of Clinical Social Work Association • Member of National Association of Social Workers
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Beth Levine, LCSW-C
6236 Montrose Road, Rockville, Maryland 20852
Hours by appointment only
Easy access from many different locations
Free and ample parking
Beth Levine Counseling
On Being: Lessons I Learn From Animals