Rachel Bernstein LMFT, MSEd
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FORMS

Before our first meeting, please download, fill out, and submit the files below to the attached contact form.
Please submit 1 file at a time.
Patient Intake Form
File Size: 3281 kb
File Type: pdf
Download File

Insurance Reimbursement Form
File Size: 342 kb
File Type: pdf
Download File

Office Agreement
File Size: 58 kb
File Type: pdf
Download File

Mental Health History Form
File Size: 44 kb
File Type: pdf
Download File

Telehealth Consent
File Size: 762 kb
File Type: pdf
Download File

Click the button below to select and pay for services.
PAY HERE
Rachel Bernstein LMFT, MSEd
16255 Ventura Blvd
Suite 806
​Encino, CA 91436
(818) 907 - 0036
© 2021 Rachel Bernstein. All rights reserved.
  • Home
  • About + FAQ
  • Services + Rates
  • VIDEOS
  • Press + Media
  • Book
  • Podcast
  • Forms and Payment
  • Contact
  • Webinar
  • PDF
  • Blog