Kristin's Comfy Couch Family Counseling
Kristin Perry, LMFT
Admissions and Assessment Forms
Admissions Forms: It is helpful if you print and complete these forms in advance and bring them with you to your first session. Thank You!
A document describing counseling process, fees, procedures etc. Requires client signature. Mandatory form.
KCC Informed Consent.pdf
Adobe Acrobat document [232.5 KB]
Please fill out before first session. Feel free to leave sections blank or write in N/A if the question does not apply to you or you are uncomfortable answering.
KCC+Assessment+forms.pdf
Adobe Acrobat document [411.3 KB]
Complete this form insteas of the adult and teen assessment form for children under the age of twelve.
KCC CHILD INTAKE ASSESSMENT FORM.pdf
Adobe Acrobat document [123.4 KB]
Informational Only- HIPPA Compliant Notice of Privacy Policies for Consumers
KCC+NPP+HIPPA.pdf
Adobe Acrobat document [55.6 KB]
Complete this form if communication with a school, doctor, court, or other outside organization or person is needed to help you. Please complete a separate form for each entity.
KCC+Authorization_to_disclose_English.pd[...]
Adobe Acrobat document [58.3 KB]
Release form describing administrative and clerical management issues related to your counseling information. Requires client signature.
KCC+clerical+AUTHORIZATION+TO+USE+OR+DIS[...]
Adobe Acrobat document [37.2 KB]
Describes the limits to confidentiality presented by electronic communication- or e-mail and establishes practice's policies. Requires client signature, or decline.
kcc+e-mail+disclosure+form.pdf
Adobe Acrobat document [87.6 KB]
Print 
Find your balance with Kristin Perry, MFT
BBS Registration #48092
Questions?
If you are a prospective, former or current client, and need to reach me, it is easier for me to respond to texts or emails and schedule phone contact:
(619) 368-9339
kristinscomfycouch@
gmail.com
Emergency Information
Please call 911
or
24 Hour
Access and Crisis Line:
800-479-3339
or
The National Suicide Prevention Hotline
800-273-8255
in the event of an Emergency.
Address and Phone
***************
Kristin's Comfy Couch
Family Counseling
2558 Roosevelt Street
Suite 201
Carlsbad, CA 92008
****************
Phone; 760-978-6071
To reach me, or schedule a time to talk, please text my cell phone number below, or e-mail me through the contact link or at the address below, it is sometimes difficult for me to talk on the phone, because I'm home with my very busy child much of the time:
Text 619-368-9339
Fax: 858-860-5299
E-mail: kristinscomfycouch@gmail.com
For all Your Carlsbad Counseling Needs
"Specializing in Teens—
and Normal People Too!"