Client Portal — thevictoriousmind

Kayla’s Client Portal

Kayla Lustosa, MA, LAPC
Specializations: Adolescents, Teens, & Adults

e: klustosa@thevictoriousmind.org

p: 706-389-8253⁩

Minor Intake Form

Adult Intake Form

Telemental Health Information Form

Release of Information Form

Parent Report Form

Notice of Privacy Rights

Authorization for Minor Treatment