Susan Pauna, MS, LCPC Therapy for Individuals, Couples, & Families
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Client Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Information Form
  • Appointment Reminder Form
  • Office Policies
  • Failed Appointment Policy
  • Credit Card Form
  • HIPAA & Confidentiality
 

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Medical Request of Information Coordination of Care Form



Note: To download Adobe Acrobat Reader for free, click here.

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Susan Pauna and naperville-therapy.com expressly disclaim all warranties and responsibilities of any kind, whether express or implied, for the accuracy or reliability of the content of any information contained in this site, and for the suitability, results, effectiveness or fitness for any particular purpose of the content. You are solely responsible for your use or reliance on such information and any foreseeable or unforeseeable consequences arising out of such use or reliance. In no event will Susan Pauna or naperville-therapy.com be liable for any damages resulting from the use of or inability to use, the content, whether based on warranty, contract, tort or other legal theory, and whether or not Susan Pauna or naperville-therapy.com is advised of the possibility of such damages. In no event will Susan Pauna's and naperville-therapy.com aggregate liability exceed U.S. $100.

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