Green Bird Nature Therapy
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FORMS

New Client Forms

Please complete (and electronically sign) these New Client forms and make sure they are submitted at least 24 hours before your first session. If your session is online, you need to complete the first four forms. If your session is outdoors (nature therapy), you also need to submit the Outdoor Ecotherapy Release Form. 

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Client Intake Form

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Professional Disclosure

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HIPAA Privacy Form

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Telehealth Informed Consent

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Outdoor Ecotherapy Release Form

Jeanne Malmgren, M.Ed., LPC, NCC, CCTP
GREEN BIRD NATURE THERAPY
PHONE: (864) 784-1077
FAX: (888) 935-2927
E-MAIL: malmgrenjeanne@gmail.com

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Jeanne Malmgren LPC Upstate Counselor | Canso Technologies, LLC | MAILING ADDRESS: P.O. Box 49 Sunset, SC 29685