Client Forms

If you are new, please feel free to fill out these intake forms before our first session.

Consent for Treatment of Minor

Child Intake Form

Authorization for Electronic Communication

Adult Intake Form

Limits of Confidentiality

Office Policies

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization to Release Information

 

Contact Today



84 Park Avenue Suite E114
Flemington, NJ 08822

kbergacs@myplaceforpeace.com
(908) 751-1208

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