Christina Culpepper, LMFT
Licensed Marriage and Family Therapist.

(615) 481-0555 or

e-mail: cculpepper5@gmail.com

Forms

If you're a new client, please complete the following forms and bring them with you. They are word documents that you can download and print. Just click on Download.

Client In Take - Download - PDF
Client In Take - Download

Confidentiality And Cancellation Policy - Download - PDF
Confidentiality And Cancellation Policy - Download


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. This is a word documents that you can download and print. Just right click on Download.

Authorization to Disclose Information Form - Download - PDF
Authorization to Disclose Information Form - Download