805-334-0023 | fred@fredharlan.net

Fred Harlan

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Client Forms

New clients, please download and fill out the following forms. Bring the filled out documents to your first session to get started more quickly, and to allow as much time as possible to focus on you.

Client Intake

Client Contact Information Sheet

Limits of Confidentiality

If would like to have your sessions collaborated with another mental health advisor, simply fill out the next form, and we can discuss the necessary arrangements.

Authorization for Release of Information

Fred Harlan, MA2

Associate Marriage and Family Therapist
License #: 112234

280 E. Thousand Oaks Blvd., Suite D
Thousand Oaks, CA 91360
Supervisor: JoHanna Jones - LMFT# 48902

805-334-0023
fred@fredharlan.net


Send Me a Message

Fred Harlan, MA2

Associate Marriage and Family Therapist
License #: 112234

Phone: 805-334-0023
Email: fred@fredharlan.net

 
280 E. Thousand Oaks Blvd., Suite D
Thousand Oaks, CA 91360
Supervisor: JoHanna Jones - LMFT# 48902

Contact

Click on the "REQUEST AN APPOINTMENT" button below to schedule a couples or infidelity counseling session with Fred Harlan. Get a consultation today and start reconnecting.

Request an Appointment

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