Reunification intake
Jason Cheney’s 2026 Mesa Valley Counseling packet: statement of understanding, fee and court terms, and the per-parent intake questionnaire.
Each parent or guardian completes their own packet · about 35 minutes · one signature
Client forms
Sign paperwork online
Complete the paperwork Jason asked you to sign before your appointment. Type your legal name to sign, then submit. The office receives the completed packet.
Do not use a public computer if you can help it. Close the browser when you finish. Emergency questions do not belong on these forms—call 911 or 988.
Open form
Couples agreement
Informed consent for marriage and couples counseling, including the no-secrets policy, fees, and agreement not to involve the therapist in court.
Both partners · about 12 minutes · 2 signatures
Release of information
HIPAA-aligned authorization allowing Mesa Valley Counseling to send and receive information with one or more named people or organizations.
The client, or a parent/legal guardian for a minor · about 10 minutes · one signature
PCIT intake
Parent-Child Interaction Therapy policies, family history, and consent drawn from Mesa Valley Counseling’s 2026 PCIT intake packet.
Parent or caregiver of the child in PCIT · about 20 minutes · 2 signatures