Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Data Form

Informed Consent

Private Practice Disclosure

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

ELC Authorization Release of Information

Request an Appointment



3717 Decatur Dr. Suite 1
Kensington, MD 20895

4329 Northview Dr.,
Bowie, MD 20716

vickye@emergelc.com
(301) 684-8270

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