top of page
Forest Trees

Hello + Welcome

Thank you for taking the time to meet with me! I am looking forward to getting to know more about you and how I can help. 

Please complete my New Client Paperwork according to the instructions below. 

New Client Paperwork

Signing a Contract

ALL New Clients complete this form. Your Good Faith Estimate is included, so please review this as soon as possible.

Informed Consent

Typewriter Keys

ALL New Clients complete this form. Share your emergency contacts, why you are seeking therapy and a bit about your personal history.

Client Information & Intake Form

Couple Hiking Outdoor

COUPLES. If you are seeing me for couples therapy, please complete this form. Each individual in the couple should fill this out independently. 

Couples Questionnaire

Holding Hands

Sex Therapy Clients. If you are seeing me for topics related to sex, sexuality, intimacy or identity, please complete this history form. 

Sexual Story & Beliefs

Morning Read

The Article. I ask that all couples clients read this article before our first session! Feel free to print, take notes, highlight, etc. 

How to Get the Most From Your Couples Therapy

Business Owner

Clients Desiring a Superbill. I suggest you use this guide to call your insurance provider prior to beginning services. 

Checking Your Coverage to See an Out-of-Network Therapist

All Hands In

All Clients who would like me to collaborate with other healthcare providers - individual/couples therapist, physical therapists, medical specialists, primary care provider, psychiatrist, etc.

Release of Information

How do I pay for sessions?

I use a HIPAA Compliant app for payment called IVY PAY. After our first session, you will receive a text with a link to a portal which will allow you to put a payment card on file and to authorize automatic charges. If you have an HSA/FSA, don’t forget that you can use these pre-tax dollars for therapy services!

You can learn about my payment policies in the Informed Consent form above.

© 2020 by Leslie Jensen, MS, LMFT. 

Proudly created with Wix.com

Access my HIPAA Privacy Notice here

A Good Faith Estimate is available upon scheduling our first session or upon request.

Access my Accessibility Statement here

bottom of page