Information and Consent Forms

If you would like to get a head-start on our work together, please complete the following forms and bring them to your first therapy session.

Intake Questionnaire

Informed Consent Form – Individuals

Informed Consent Form – Couples

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

Consent to Release Confidential Information

Don Waxman, MFT
2805 Eastman Lane
Petaluma, CA 94952

Offering therapy and counseling services to Petaluma, Novato, Rohnert Park, Sebastopol, Santa Rosa, Sonoma, North Bay.

Couples Counseling, Relationships, Marriage, Men’s Issues, Men’s Group, Anger, Depression, Grief, Anxiety, Loss, Marriage Counseling, Cognitive Behavioral Therapy, Domestic Violence, Individual Therapy, Family Therapy, Group Therapy, Addictions, Sex Addiction, Aging, End of Life, Bereavement, Somatic Psychotherapy, Mindfulness, Focusing, Work-Related Issues, Emotional Resilience, Mood Stability, Solution-Focused Therapy, Brief Therapy

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