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Nicole Rogers
500 mts sur de la escuela Cedral,
Palmitas, Cariari
Pococi, Limon 70203
Costa Rica

If you're a new client, please complete the following forms and bring them to your first therapy session. You can click on the link and edit the word document. Ones in bold are required for ALL clients. At your first session, we will review the completed forms and discuss your treatment history, goals for treatment, and confidentiality. I do not have a waiting room, so, please do not bring with you anyone that you do not wish to have in session with you. Office hours are by appointment only. Parking in spots marked "Visitor" is available for clients; please do not park in any spot marked "Reserved".


If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Brochures/ information: userfiles/576247/file/Brochure basic(3).pdf

In the event you expect that you would require me to testify in court on your behalf, the following document only pertains to legal testimony & release of info :        userfiles/576247/file/Consent for Court Testimony.pdf