Abundant Living Psychological and Coaching Services for Children and Adolescents
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Useful Forms


For your convenience and to save you time in the office, please print out, complete the following forms, and bring them to your first appointment.  Forms are also available in the office, if you prefer to fill them out there.  Please arrive 15 minutes before your scheduled appointment to complete the forms before you meet with a psychologist or counselor.

client_intake_forms.pdfPlease read the Notice of Privacy Policies and Client Rights Responsibilities Forms.  If you are a new client, keep a copy of each for your records.
  • Notice of Privacy Policies Form
  • Client Rights Responsibilities Form

If you would able, please bring the completed Intake Forms (below) to the first appointment:
  • Client Intake and Consent Form
  • Developmental History Form

The following is form provides the Coaching Guidelines and a copy of a Coaching Contract that will be completed at your first office visit.
  • Coaching Contract


If you would like Abundant Living to bill your insurance or would like your psychologist or counselor to coordinate care with another medical provider, please complete the Authorization to Release or Exchange Information Form.
  • Authorization to Release or Exchange Information Form
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verified by Psychology Today
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Accepting Insurance:
    TRICARE
    United Behavioral Health
    Some KY Medicaid Plans
    Some KY Medicare Plans
    BlueCross/BlueShield

 EMAIL FOR MORE INFO!!!




Email: drshambramulder@abundantlivingpsychologicalandcoachingservices.com