New Group Forming, “True Self,” and “Mixed Emotions.” Email for details.

Marni Millet, LCSW

Marni Millet, LCSW Marni Millet, LCSW Marni Millet, LCSW
  • Home
  • About Me
  • Daily Insights
  • My Approach
  • Intake Forms
  • Billing and Insurance
  • RESOURCES
    • Home
    • About Me
    • Daily Insights
    • My Approach
    • Intake Forms
    • Billing and Insurance
    • RESOURCES

Marni Millet, LCSW

Marni Millet, LCSW Marni Millet, LCSW Marni Millet, LCSW

  • Home
  • About Me
  • Daily Insights
  • My Approach
  • Intake Forms
  • Billing and Insurance
  • RESOURCES

Intake Packet

Please print and complete the following intake forms to bring with you to your first appointment.  If using insurance, please visit  https://obriensbilling.com/  and complete the PATIENT INTAKE QUESTIONNAIRE to submit your insurance plan information.

Intake Form 2020 (pdf)Download
HIPAA (pdf)Download
Informed Consent 2020 updated (pdf)Download
Video consent 2020 (pdf)Download
Telehealth policy (pdf)Download
kareo_card_on_file_authorization_form (docx)Download
Consent 2020.pdf (pdf)Download

Copyright © 2020 Marni Millet, LCSW, CASAC - All Rights Reserved.