Forms

FORMS

New Client Information and Informed Consent Packet

Authorization to Release Information

Social Media and Internet Boundary Policies 2018

Doctor/Therapist Referral Form

 

ASSESSMENTS

As part of your treatment, you may want to complete one or several of the following assessments and provide the results to the therapist.  Please note, these assessments were created by others and appropriate references are included in the individual assessment document.

Assessment of Sexual Function/Dysfunction

Mass Med Sexual Function Questionnaire

Sexual Symptom Assessment Scale

SES/SIS Sexual Desire Questionnaire


Male Sexual Functioning Assessments

Brief Sexual Functioning Inventory (Male)


Female Sexual Functioning Assessments 

 

Female Sexual Functioning Index

Decreased Sexual Desire Screener


Assessment for Sexual Compulsivity and Sex Addiction

PATHOS Sex Addiction Screening Tool

Sexaholics Anonymous Test Yourself (Link)

Sex and Love Addicts Anonymous 40 Questions of SLAA

Sex and Love Addicts Anonymous Am I Anorexic? 50 Questions for Self-Diagnosis

Sex Addicts Anonymous Self-Assessment (Link)

Sexual Compulsives Anonymous 20 Questions (Link)

Sexual Recovery Anonymous Do I Belong (Link)

Standard Sex Addiction Test

Sexual Symptom Assessment Scale

Assessment of Sexual Orientation

Klein Sexual Orientation Grid

The Kinsey Scale