Andrea Keith, LMFT, CEAP, CAMF

Therapy & Counseling for Adults, Children, Couples and Families in Irvine & Newport Beach, CA

Patient Forms

Please download and complete these forms and bring with you to our first session.

Intake Form

Consent to Release

Health Inventory

Authorization to Treat a Minor

Client Agreement

EAP Client Agreement

Client Pet Loss Information

These forms require the free version of Adobe Acrobat Reader. Please click here to download if necessary.

Andrea Keith
(949) 650-2442
(714) 836-4320 Fax
Offices in
Irvine & Newport Beach