NEW CLIENT REGISTRATION INSTRUCTION

Welcome!

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. . . and follow the online instructions. Only you and I will have access to his information.

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Note: You can also enter your credit card information if you would like to pay by credit card. This can be used for each session without having to present the card to me. Once you enter the credit card information, no one will have access to that information as it will be secured in a independent credit card program. You can return here at any time and change the card info or switch cards entirely if you wish. Cards accepted are Visa, MasterCard and American Express as well as Visa/Mastercard Debit Cards.

You can also pay for each session by cash or check.

Note for COUPLES Therapy:

Each person needs to set up their own registration.

Each member of the couple needs to individually register online, so that would be two different signups.

When you fill out the online forms, PLEASE SIGN THE BOTTOM OF THE INTAKE FORM in order to complete the registration, it is pictured below. Without this signature, the process is incomplete. Any questions, please ask! Thanks.

Once this is done, we can set a first session day/time. When online registration is complete, please text me, 925 256-8282, email me at don@don-elium-psychotherapy.com or call 925 256-8282, and we can set the first session day/time.

Also note, it is really easier to register on the site than it is to explain it!

I look forward to meeting with you soon!

Sincerely,

Don

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