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Paperwork for New Clients

Information for Clients
Before completing the following Intake please read this document carefully.

Intake
Please click here to complete and submit your intake paperwork to Dr. Erwin electronically.  
The intake will take you approximately 30 minutes to complete.  Please complete and submit
the paperwork
before noon on the day of your appointment to allow Dr. Erwin time to
review it before your appointment.

For Horizon Health Clients Only
If you are a Horizon Health client,
please print and sign this document and bring to your first session.
 
Don't forget to bring your Horizon Health Authorization number.
to your first session
.
Terry McVannel Erwin, Ph.D.
Dr. Erwin is a General Practitioner With a Special Interest in
Working with Women Survivors of Childhood Sexual Abuse
Qualified Supervisor, FL
Certified in Clinical Hypnosis
National Certified Counselor #78891
Licensed Mental Health Counselor #MH8591
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PLEDGE TO LGBT CLIENTS

AFFIRMATIONS AND MORE

PAPERWORK FOR NEW
CLIENTS

DOWNLOADS FOR CURRENT
CLIENTS

DIRECTIONS TO OUR OFFICE





2506 Del Prado Boulevard South
Cape Coral, FL  33904-4750
Ph. (239) 242-0545
TErwin1@yahoo.com

Don't have insurance?
We offer limited-session sliding
scale fees that are comparable to
insurance co-pays!  
Call today for more information!