Switch to Accessible Site
Sandra Milton, LICSW, ACSW
Therapy for Individuals, Couples, & Families
Sandra Milton
253-858-2224, ext 305
6712 Kimball Drive, Ste. 103
Gig Harbor, WA 98335
Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Disclosure Form
  • HIPPA Form
  • Intake info Cover Sheet 
  • Limits of Confidentiality/Therapy Cancellation Policy

If you have questions regarding your insurance coverage, the Insurance Questionnaire form is a useful tool to use when contacting your insurance company.
If you will be using a credit/debit card to pay for your sessions/co-pay, please complete the Client Easy Pay form.

Thank you!  I look forward to meeting with you!

intake info cover sheet  
Client Disclosure Form  
HIPPA form  
Limits of Confidentiality/Therapy Cancellation Policy  
Insurance Questionnaire  


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