Forms

Client Portal (New Client Paperwork)

Our clinic is  paperless!  To complete the New Client Paperwork, fill out your demographic information and electronically sign all documents, contact Amanda Petrik to access your password to your account.  In addition, access your invoices, pay your balance, and share files to and from the therapist via this portal.  Contact Amanda at AmandaPetrikLCPC@gmail.com or 785-477-9117.


Privacy Policies

Please keep/view for your records.


Release of information

If you would like me to coordinate care with another provider, such as a psychiatrist, physician, school, or your workplace, please fill out and bring the following form.