New Client Forms

Attached are the forms which we’ll need to begin the therapy process. Please fill out, sign and return:
Also please text or send me a copy of your insurance card if you have Cigna insurance
ONLY. I do not bill any insurance other than Cigna.

Informed ConsentAcknowledgement of Receipt of Privacy PracticesIntake InformationPayment AuthorizationConsent for Tele-medicine

Please read the Privacy Practices which can also be downloaded for you to keep.

Privacy Practices

Most counseling sessions are done via telehealth from the comfort of your home. Access can be simply achieved with a smartphone, tablet or computer. Leanne will walk you through the simple process. She also provides some sessions from her comfortable office located in Huntington Beach. She'll do her best to return all calls, texts and emails by the next business day.

Address and Phone:

16152 Beach Blvd. Suite 269, Huntington Beach CA 92647
Email: leanne@leannehartmft.com
Phone: (714) 514-3779

Hours of Operation:

Monday, Tuesday and Thursday 9:00 A. M. to 6:00 P.M.
Wednesday 2:00 P.M. to 6:00 P.M.

Send me a message below:

    Your Name (required)

    Your Email (required)

    Phone

    Subject

    Your Message

    [recaptcha]