John Jeffers, LCSW Psychotherapy for Individuals, Couples, Families
Schedule an AppointmentContact Me
John Jeffers, LCSW
(207) 594-9399
15 Tea Street
P.O. Box 77
Rockland, ME 04841-3019
john@johnjefferslcsw.com
HELPFUL FORMS

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

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

  • Consent to Release Information Form

 

 DISCLAIMER

The information on this site is intended only for educational usage and should not be treated as behavioral or medical advice. The information here should not be intended in any way used for a medical or psychiatric diagnosis or treatment or as a substitute for consultation with a licensed health care provider. If you have any questions or other health related concerns, please contact and consult your health care provider.


Client Intake Form
Confidentiality and Cancellation Policy
Consent to Release

Note: To download Adobe Acrobat Reader for free, click here.

©2010 by TherapySites.com. All rights reserved.