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Melody Fortenberry, Ph.D, LMFT
Therapy for Adults, Children, Couples, & Families
Fill in Prior to First Visit:
Information Form for Adult Patients
Information Form for Children - to be Completed by Parent
Fees, Office Policies and Procedures
Notice of Privacy Practices
Background Questionnaire for Adult Patients
Background Questionnaire for Children - to be completed by Parent
Background Questionnaire for Adolescents
Authorization for Dr. Fortenberry to release records
Authorization for a third party to release records to Dr. Fortenberry
Start your new path in life and be the change today!
Click here to view and print forms for your appointment.
Melody Fortenberry, Ph.D.
6750 Hillcrest Plaza Drive
Dallas, Texas 75230