LIFE HEALING ITSELF
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Forms


Please fill out and send these forms back to me prior to your first session.
kl_intake_paperwork_2019.doc
File Size: 69 kb
File Type: doc
Download File

kl_hipaa_consent.docx
File Size: 13 kb
File Type: docx
Download File


Please download and read HIPAA.
hipaa.pdf
File Size: 76 kb
File Type: pdf
Download File


If I am in-network with your insurance plan and you plan to use your benefits, please fill out and send these forms back to me prior to our first appointment. No need to complete these forms if you plan to file for out-of-network benefits.
insurance_verification_form.docx
File Size: 506 kb
File Type: docx
Download File

insurance_benefit_information.docx
File Size: 14 kb
File Type: docx
Download File


I have one pay-what-you-can slot available for activists. If you would like to apply for this slot, please fill out this application and return it to me. I will review it and let you know if you are accepted as I am able!
application_for_pay-what-you-can_slot.docx
File Size: 25 kb
File Type: docx
Download File


Picture

​The way of love is not 
a subtle argument. 

The door there 
is devastation. 

Birds make great sky-circles 
of their freedom. 
How do they learn it? 

They fall, and falling, 
they're given wings.

​~ Rumi
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Kristin Leonheart, M.S., LMFT
© All rights reserved

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Hours:
Monday 12pm-8pm
Tuesday 10am-8pm
Wednesday 2pm-6:30pm