New Client Forms

Please download, fill out and bring these to your Intake session:

DBT Eastside New Client Intake Form

DBT Eastside Explanation of Therapy

Continuing Client Forms

Please download these forms as your therapist recommends during counseling or coaching sessions:

DBT Eastside Phone Coaching Worksheet Expectations

DBT Eastside Diary Card for All Clients

DBT Eastside Difficulties in Emotional Regulation Scale (DERS)

Forms for Family Members

Please download these forms and bring them to Intake or your first Parent/Affected Others' Skills Group to help us support your family's well-being:

DBT Eastside Parent/Affected Other/Caregiver Group Intake Form

Forms for Healthcare Providers

Please download and fax these forms to us so that we may support your clients

DBT Eastside Fax Number: 1-425-207-4961

DBT Eastside Referral Form for Referring Mental Health Therapists

DBT Eastside Release of Information (ROI) Form for healthcare providers