Rhoda Banks

LCSW LLC SAP

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203-775-6269
246 Federal Rd. Suite C-33B Brookfield, Ct. 06804
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Client Forms

If you are a new client of Rhoda Banks, please be sure to download and complete the following forms. Then, bring your completed forms with you to your first meeting/session. This will help ease you into therapy, and allow as much time to be spent on you as possible.

Client Contact Information Sheet

Client Intake

Limits of Confidentiality

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 for Release of Information


Rhoda Banks

LCSW, LLC, SAP

203-775-6269
rhodabanks8@gmail.com

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