robin@septembercounseling.com | 720-619-3998
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720-619-3998 | robin@septembercounseling.com

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  • Home
  • About
    • Why September?
    • Happy People
  • Services
    • Individual Therapy
    • Group Therapy
    • Teletherapy
    • Training Services
  • Getting Started
    • Appointment Request
    • Helpful Forms
    • General Counseling FAQS
    • Rates and Insurance
  • Resources
    • Recent News
    • Mental Health Links
    • Physical Health Links
  • Blog
  • Contact
  • Facebook
  • Instagram
  • LinkedIn
720-619-3998

robin@septembercounseling.com

What you'll discover is yourself Get Started

Helpful Forms

If you’re a new client, please complete the following forms (choose the one intake form that fits for you) and send them to me via email or bring them with you to your first therapy session.

  • Adult Client (15+) Intake Form
  • Tween/Adolescent Intake Form
  • Child Intake Form
  • HIPAA_Notice of Privacy Practices
  • Mandatory Disclosure Statement
  • Consent for Treatment/Practices and Policies
  • Therapy Cancellation and No Show Policy

If you would like me to coordinate care with another provider, or if there is someone you would like me to able to talk to regarding your treatment (for example, your psychiatrist, primary care physician, mother, etc.), please complete this form to authorize release of psychotherapy information and bring it with you to your next session:

  • Authorization for Release of  Information

Contact Today

80 Garden Center, Suite 136
Broomfield, CO 80020

720-619-3998
robin@septembercounseling.com

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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Robin J Sackmann, LPC

720-619-3998
robin@septembercounseling.com

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