Serving families in the 
Lehigh Valley since 2014
(484) 863-9220

Valley Family Therapeutics, LLC


Patient Forms

All forms can be downloaded, completed, and sent to Valley Family Therapeutics through:

Fax: (484) 353-5157

Email: [email protected]

Please fill out the following forms and bring with you to the first treatment session:

Permission to Treat Form 

Patient Intake Form

Financial Agreement and Insurance

HIPAA Release Form

Autism Evaluation Forms