Anchor Psychology, Inc.
  • Home
  • About Us
    • Janelle Bull, LMFT
    • Jamie Williams, LMFT
    • Evagelia ("Evelin") Stamatis, LMFT
    • Shana McLean Moore, CTACC
    • Andrew Maldonado, LMFT
    • Dave King, LMFT
    • Eriko Timbers, LMFT
    • Kimberly ("Kim") Picchi, AMFT
    • Betty Nelson, AMFT
  • Blog
  • Our Offices
  • Contact Us
  • New Client Forms

New Client Forms

 If you are a new client, please fill out these forms and bring to your first appointment.
Outpatient Services Contract
File Size: 170 kb
File Type: pdf
Download File

Additional Fees
File Size: 78 kb
File Type: pdf
Download File

ADULT Intake Form
File Size: 187 kb
File Type: pdf
Download File

MINOR and YOUNG ADULT Intake Form
File Size: 198 kb
File Type: pdf
Download File

Credit Card Authorization Form
File Size: 101 kb
File Type: pdf
Download File

Authorization for Release of Information
File Size: 72 kb
File Type: pdf
Download File

Informed Consent for In-Person Services During COVID-19
File Size: 214 kb
File Type: pdf
Download File



Let us help you anchor your soul. 


1975 Hamilton Avenue
Suites 11 & 37
San Jose, CA 95125

Take a virtual tour of both our offices!


main: 408.340.5875
fax: 408.340.5875
email: ​anchorpsychmft@gmail.com

​Open Monday - Friday, 8:00am - 8:00pm

  • Home
  • About Us
    • Janelle Bull, LMFT
    • Jamie Williams, LMFT
    • Evagelia ("Evelin") Stamatis, LMFT
    • Shana McLean Moore, CTACC
    • Andrew Maldonado, LMFT
    • Dave King, LMFT
    • Eriko Timbers, LMFT
    • Kimberly ("Kim") Picchi, AMFT
    • Betty Nelson, AMFT
  • Blog
  • Our Offices
  • Contact Us
  • New Client Forms