Helpful Forms

If you're a new client, please complete the following forms and bring them to 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:

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

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Links & Resources

View recommended websites and other valuable resources.

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Helpful Forms

Click here to view and print forms for your appointment.

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Gena Patackas

(570) 382-3122

106 Colburn Ave Clarks Summit PA 18411

1005 Main Street Suite 3  Peckville PA 18452
United States

[email protected]

Client Portal