New Client Form
Hello and welcome to Forward Thinking Mental Wellness!  Thank you for you interest in accessing Nikkie Rossetti's psychotherapy services.  Please fill out the information below, then you will be sent a Client Portal request through Simple Practice.
Email *
Name *
Phone number *
Can you receive text messages? *
Address *
Please provide 3 options for your ideal availability for therapy sessions (e.g. "Tuesdays at 11am or 12pm,  Fridays at 12pm", "weekdays at 3pm", "any weekday morning except Monday", etc. You can feel free to include your existing appointment time if it's preferred). *
How did you hear about us? *
If there's anything else you'd like to share, please feel free:
Thank you!
I appreciate you taking the time to complete this form.  Next, you will be sent a Client Portal request where you can sign up to view the legally-required documents for therapy, such as Informed Consent, HIPAA Authorizations, payment info, and more.  Please feel free to reach out at any time with questions.
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