Client Intake Forms

How This Works

  1. Find the form(s) that you need from the list below.
  2. Click each one that you need. (Each clicked file will automatically download.)
  3. Open each downloaded file and print it out on any printer.

What's Next?

  1. Complete each form.
  2. Bring it with you to your first appointment.


See you soon!

Kip Rodgers LPC-S


About Kip Rodgers


Kip Rodgers-BrainCode Corp

Every day, I read the headlines about athletes who struggle and end up making poor choices. Memorable headlines include Junior Seau and Johnny Manziel. Recent headlines include the horrific abuse in USA Gymnastics and the suicide of a D1 quarterback at Washington State.

The banners I read show athletes get arrested, released, benched, sustain career-ending injuries, and get taken advantage of by others. And, on occasion, an athlete makes the drastic choice to take their life leaving behind stunned teammates, family, friends, and fans.

This drives me. It wakes me up every day with purpose. Why? At 15, I was one of those athletes contemplating suicide...

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