Forms

In order to use our time well in the first session, you have the option of printing out and bringing with you  a completed Client Contact Information Form  a signed Confidentiality Agreement and sliding scale OFT Fee Schedule 2017.  Please fill out one copy for each adult member who intends to be an active part of the counseling process. If you would like me to be in contact with other professionals involved in your care, such as medical doctors or therapists, a signed release of information will also be needed – something we can do in our first session together. In addition, you may wish to review the Office Policies and feel free to ask any questions that come up for you.

Debra Seido Martin, MA MFT, LPC Phone: 541-844-4917     Email: openfieldtherapy@gmail.com Office: Neighborhood Location Near 11th & Chambers, Eugene, OR