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If you are new to Marriage Rx, please complete either the Individual Intake Form or Couple's Intake Form prior to your initial counseling session, which are accessible at the bottom of this page.  This will save time at the initial visit.  Please complete and bring them to your first appointment.

If we will be coordinating care with a physician or other providers, please fill out the Release of Information form below.
 

Individual Intake

Couples Intake

Release of Information



For any questions or to schedule an appointment please e-mail us at: btopalof@msn.com