Christine Ubben, MA, LPC, LAMFT Counseling for Individuals, Couples & Families in Burnsville and Neighboring Communities

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Christine Ubben, MA
Licensed Professional Counselor
Licensed Associate Marriage and
Family Therapist

Office cell:  (952) 288-4091

christine@ubbencounseling.com

New Client Forms

If you are a first-time client, please review the following:

Complete the 3 forms listed below and bring them with you to the first session:

  • Client Information
  • Checklist of Concerns
  • Acknowledgment of Receipt & Review of General Informed Consent & HIPAA Forms *
* Please review the 3 forms listed below before you sign the Acknowledgement form above.  These forms are not necessary to bring with you to your first session.
  • General Informed Consent
  • HIPAA - Notice of Privacy Rights
  • HIPAA - Office Privacy Policies and Procedures

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



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