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Client Forms - Kim Saltzman

Client Forms

Downloadable forms for your convenience

Client Information Packet

To download the forms and information you need, simply click the links provided. For added convenience, our forms can be downloaded and saved for future use.

You can print and complete these client forms in advance. This will allow us to process your information more rapidly and potentially get you treated more quickly.

If you need to give authorization regarding treatment of a minor or to disclose your health information to another provider, we’ve provided the necessary form here.

Client Testimonial #6
I personally recommend Kim. My experience of Kim is that she has that special, unique ability to combine personal experience, authenticity and growth with professionalism. Her willingness to be real with her clients as well as her ability to combine creativity and insight into her work is a true gift. I am confident in Kim and her work.
Professional Colleague Jean Dixon, LPC
Client Testimonial #5
I have had the pleasure of knowing Kim Saltzman in both a personal and professional capacity for over ten years. Kim is a gifted and insightful therapist who skillfully uses her professional training, Christian faith and life experience to assist her clients. Kim is one of the most exceptional counselors I have met and I highly recommend her.
Professional Colleague
Lois Thomson Bowersock, LCDC
Client Testimonial #4
Kim exemplifies someone who truly is in counseling because she has a genuine heart to see people healed and restored. Her empathy and compassion speaks volumes about her and makes her so easy to talk to and trust. Trust is something that has never come easily to me but Kim sets up an atmosphere that puts me at ease and gives me the space to talk with freedom. Her mastery and understanding of current therapy techniques has helped to change and restore my life! I owe so much of my recovery to Kim and she truly helped to save my life from the pit. I have learned from Kim that there is always hope for recovery and healing and it is okay to make mistakes and not be perfect. Kim never judges nor condemns and shows me grace and compassion even when I don’t deserve it. She is definitely a blessing from the Lord!!!!
Anonymous Client
Client Testimonial #3
Kim has an amazing way of helping you realize the truth that is already in you. She helped me to see the reality of my codependent relationship with an addict. I stayed in the relationship because I couldn't fathom living without him. Kim not only helped me to find the inner strength to get through that lost relationship, but I am now grateful for it! Kim has helped me discover the tools necessary to deal with things that life throws at me in a healthy way. I would not be where I am today without her help! Her easygoing and caring nature makes me feel comfortable sharing the things that I have kept to myself for years, and with her wisdom and insight I have learned to deal with these things that hidden, have been hurting me for so long.
Anonymous Client
Client Testimonial #2
My connection with Kim was immediate. I found someone that truly identified with the problem I was facing. I received immediate feedback during each of my sessions. How refreshing when you have had prior counselors prompt you to talk about yourself for an hour only to tell you “time is up, good work, and when can you come in next.” My only regret is the loss of time and money spent on two other counselors before I found Kim.
Anonymous Client
Client Testimonial #1
When I first sought treatment for my eating disorder and addiction to self-harm, I was terrified of being dismissed by a professional as a “fake who was not truly sick.” Kim did nothing but affirm my decision to get help before things escalated further though. From our first session onward, she has been a beacon of light: shinning God’s truth and hope into the overwhelming darkness of addiction. She’s encouraged me through rough patches; celebrated milestones with me; firmly held me accountable in the most loving of ways possible; and maintained a steadfast honesty with me, regardless of the truth being something I wanted to hear verses something I needed to hear. With strength from God and guidance from Kim, I’ve begun climbing my way out of the hole of my struggles.
Anonymous Client