info@serenityxcelledcounseling.com | (813) 501-3124
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info@serenityxcelledcounseling.com | (813) 501-3124

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  • Home
  • About
  • Services
    • Counseling for Depression
    • Counseling for Anxiety
    • Counseling for Social Anxiety
    • Counseling for Trauma
    • Counseling for PTSD
    • Counseling for LGBTQIA+ Individuals
    • Counseling for Life Transitions
    • Counseling for Men’s Issues
    • Counseling for Conflict Resolution
    • Telehealth
  • Getting Started
    • FAQs
    • Rates and Insurance
    • Client Forms
    • Appointment Request
  • Contact
  • Blog
  • Facebook
  • Instagram
  • LinkedIn
  • Twitter
(813) 501-3124

info@serenityxcelledcounseling.com

Client Forms

If you’re a new client, you will receive a separate email communication to complete the required forms for your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, Click here.

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(813) 501-3124
info@serenityxcelledcounseling.com

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

About Us

We specialize in treating individuals, couples and families, and through our experience, we are confident that no problem is too great to overcome.

Office Hours

Office Hours are Available by Request

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Contact Information

(813) 501-3124
info@serenityxcelledcounseling.com

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