Reflections Counseling
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  • Home
  • Counseling Services
  • Meet our Psychologist
  • Psychological Testing
  • Meet Our Therapists
  • Patient Forms
  • Consultation & Supervision
  • Insurance & Payment Options
  • Contact Us
  • COVID-19 Response
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YOUR CART

For your convenience we have added some of the forms you will be asked to fill out during your first visit. You may download these and fill them out at your leisure.  If you choose to complete the forms before your first appointment, please remember to bring them with you.  
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If you are interested in psychiatric services, please note that Dr. Knapp's forms are different from the psychological testing and counseling forms found on this page.  Click here to view Dr. Knapp's policies as well as contact her to set up an appointment.
New Patients
  • New Patient Forms
  • ​Social Media/Technology Agreement

​Current Patients
  • HIPAA Acknowledgement
  • Release of Information Form
  • Financial Policy
  • ​Court Policy ​


​To return to the Home page, click here.

​3220 E. Jefferson Blvd.
South Bend, IN 46615

Phone: (574) 222-2466
​Fax:  (574) 222-2468
​Email: ​info@reflectionsmichiana.com
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