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Surprise Behavioral Health

Quick Contact Tel: 623-337-3388

Email: Click here

Important Message Regarding Coronavirus:

The CDC has recommended limiting your time in public spaces. Consider Telehealth for your healthcare needs to limit your exposure.

Get Telehealth Services Now

Are you ready for your journey to begin?

Ruth J. Cohen, LMFT
Surprise, AZ 85387
623-337-3388

Download Forms

(PDF Files - Open & Print)

What to Expect on Your First Visit

Credit Card Payment Authorization Form

Individual-Therapy After Couples Therapy Agreement

Insurance Verification Form

Notice of Privacy Practices

Notice of Privacy Practices Receipt

Social Media Policy

Adult Information Form

Couples Therapy Participation Agreement

Adolescent Information Form

Client Intake Form

Ready to Leave Therapy

HIPAA Authorization Form

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