(203) 450-4745 | admin@nourishtheheartcounseling.com

Joy Zelikovsky

My WordPress Blog

  • Joy Zelikovsky
  • Home
  • Therapy
    • Individual Therapy
    • Group Therapy
    • Accelerated Resolution Therapy (ART)
    • Eating Disorders
    • Supervision
    • Telehealth
    • Monthly Community Program – ‘Why Diets Don’t Work’
    • Therapy for Walk & Talk
  • Providers
    • Joy Zelikovsky, Psy.D., M.A., M.Phil.Ed., M.S.Ed
    • Sam Chasse, Marital & Family Therapist
    • Alyssa Battipaglia, LMFT
    • Simone Tartaglia, RDN
    • Sarah Iannacone, MSN, APRN, PMHNP-BC
    • Kendra Brown, M.A., doctoral student intern
    • Isabella Randazzo, LCSW & CIEC
    • Kelsey Gilbert, Eating Disorder Recovery Coach
    • Ken Miki, LMSW
  • Practicum Students
  • Getting Started
    • Finding the Right Therapist
    • Appointment Request
    • Client Forms
    • FAQs
    • Rates & Insurance
    • Good Faith Estimate
  • Resources
    • Mental Health Links
    • Physical Health Links
  • Blog
  • Contact

Client Forms

If you are new to therapy or counseling, please be sure to fill out the following forms, and bring them to your first session. This will help ease you into therapy and allow as much time as possible to focus on you.

Client Intake

Client Information

Authorization for Release of Information

Limits of Confidentiality

Telehealth Emergency Guidelines

Practice Policies Simple Practice

Notice of Privacy Practices Simple Practice

Informed Consent Simple Practice

Adolescent Consent Forms Simple Practice

Consent for Telehealth Simple Practice
 

Contact Today

Joy Zelikovsky



(203) 450-4745
email me

Contact

Send A Message

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.

Office Hours

Office Hours are Available by Request
Request An Appointment
  • Facebook
  • Instagram
  • LinkedIn
  • Twitter

Emergency Information

We do not provide emergency services. content to come...

Contact Information

(203) 450-4745
admin@nourishtheheartcounseling.com

A Therapist Website by Brighter Vision | Privacy Policy