EFT with Patrick L. Healey Ph.D., M.F.T. is Located in Irvine, CA
Call Today: (949) 514-4186 | Email: eft@therapy4two.com | Directions

Questions & Appointments

Simply send us the following information and we will contact you to schedule an appoinment or answer any questions you may have. All calls are confidential.

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Client Forms

Please print, complete and bring these forms with you for your first session with us.

• New Patient Intake Form : Download PDF

• Couples Questionnaire : Download PDF

• EFT Dyadic Adjustment Scale (survey) : Download PDF

• Permission to Video/Audio Tape Counseling Sessions : Downlaod PDF

• HIPPA Notice of Privacy Practices : Download PDF

• HIPPA Consent Form : Download PDF

• Credit Card Authorization : Download PDF

• Payment Responsibility Form (if other than patient): Download PDF