New Patient Forms

We would like to welcome you to the office of Dr. Debra King and Family C.A.R.E Services. In an effort to save time and for your convenience the new patient forms are in electronic format. You may complete these forms using a computer, tablet, or smart phone.

Once you hit the submit button, the completed form will be sent directly to our office. * Please be aware that certain fields are required to be completed before it can be submitted to the office. You may upload a copy of the front and back of your insurance cards when completing the New Patient Welcome Form.

Once all forms are received a member of our team will reach out to you to schedule your initial appointment. If you experience difficulty completing these forms please contact the office for assistance.

If you're a new client, please complete the following forms and bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:


Note: To download Adobe Acrobat Reader for free, click here .

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Helpful Forms

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Debra King, PhD, LPC, LPCS, NCC, TESOL, LAC, LCMHC 
864-888-7310
3505 Pelham Road
Suite B
Greenville, SC 29615-4185
US

[email protected]