About My Practice - Kimberly Greene
Psychotherapy / Mental Health Services for Adolescents (10 years and up) and Adults
Owner & Facilitator of "Release & Renew Retreats"
To schedule an individual, adolescent, couples, or family therapy appointment, please call me at 916-757-2681. Once you have a scheduled appointment, please download, print, and fill in the forms below. Please bring your completed forms to your first appointment where we will discuss any questions you may have.
FORMS: Patient Services
- Financial, Cancellations/Missed Appts, Credit Card Agreement
- Consent for Treatment
- Consent for Treatment of a Minor
- Health Insurance Portability and Accountability (HIPAA)
- Patient Packet (above four forms)
FORMS: Child/Adolescent Therapy
FORMS: Adult Therapy
Click on a form to download. All forms are in PDF format. For questions, please contact Kimberly Greene.
Kimberly Greene, LMFT
Psychotherapy / Mental Health Services for Adolescents and Adults
1899 E. Roseville Parkway, Suite 100, Roseville, California 95661 | 916-757-2681