Smith Intervention Solutions Take Action Now!

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Gifford "Giff", Smith
(818) 889-6264
giffordsmith@earthlink.net
Helpful Forms

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

  • Questinnaire - Is Intervention Indicated?
  • Pre-Admission Assessment Form 
  • Limits of Confidentiality/Therapy Cancellation Policy

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:

  • Authorization to Disclose Information Form

Questionnaire - Is Intervention Indicated?
Pre-Admission Assessment Form
Authorization to Disclose Information Form

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