Forms

 

To save time on your initial visit, please print out and complete the two forms  below:  

    (You will need an Adobe® Acrobat reader to view and print out the forms. If you do not have a reader, or are having trouble printing out the form, you can obtain a free and current copy through this link.)

  • Client Intake Form (pdf file) This form provides me with some general background information and contact information.
  • Client Consent Contract (pdf file) This Agreement is intended to provide you with important information regarding the practices, polices and procedures and to clarify the terms of the professional therapeutic relationship between Therapist and Patient.

 

Optional Forms: These forms may be required.  If either, or both, are needed, I will let you know.

Updated 12/11/15

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Mary M Buxton LCSW, Inc. - Sex & Couple Therapy - Licensed Clinical Social Worker  #LCS 7780
15951 Los Gatos Blvd., #14, Los Gatos CA 95032 -  Phone: 408. 371.4847 -  Email Mary

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