John Jeffers, LCSW Psychotherapy for Individuals, Couples, Families

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John Jeffers, MS, MSW, Lic. Clinical Social Worker
(207) 592 4384
21 Limerock Street
P.O. Box 77
Rockland, ME 04841-0077
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  

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