Claire Bratt-Leal, MS, LMHCA
Individual Therapy for Teens and Adults
Family and Couples Therapy
Redmond Counseling Services, PLLC
8201 164th Ave NE, Suite 307
Redmond, WA 98052
(425) 324-3938
claire@redmondcounselingservices.com
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Professional Requirements
Psychotherapy should consist of a supportive and honest relationship. It is important that you receive certain
information, as dictated by the state, prior to the initial therapy session. The first part of this statement consists of
information that all counselors are required to disclose to their clients; the latter part is professional information about me
and my practice.
I welcome any questions or concerns about treatment. If for some reason you feel I have not fully addressed your
concerns, you may contact my supervisor at (425) 503-9845. You have the right to decide the therapist who best suits
your needs and purposes. You also have the right to discontinue treatment at any time, although I would encourage your
ideas or thoughts before the decision is made to allow for mutual understanding.
Client Rights
I will not release any information without your written permission, with the following exceptions (as required by
Washington state law (RCW 18.19.180). In cases of the following your information may be disclosed: suspected child
(or dependent adult) abuse; if you are a physical threat to yourself or others (i.e. suicidal or homicidal threats); or in the
rare case of a court subpoena. I am involved in consultation groups with other professionals in which the general details
of cases may be discussed to better meet the needs of our clients, yet without revealing any identifying information about
you or your family. My supervisor is also kept informed of the therapeutic progress of my clients.
My Background and Therapy Methods
I hold a Bachelor of Arts degree in the field of psychology from the University of Washington and a Master of Science
degree in Professional Counseling from Grand Canyon University. As required by the state of Washington, I am
providing counseling under the supervision of a licensed and practicing therapist, Renee Balodis-Cox, LMHC. This
means that my supervisor and I consult regularly on the needs and progress of my clients as well as the course of
treatment planned. I am also a member of the American Counseling Association.
My method of therapy is based on drawing on an individual’s strengths and awareness in order to build the skills
needed to navigate life’s stressors and achieve a sense of well-being. I like to emphasize positive psychology,
integrating elements of humanistic and Person-Centered therapies to help clients learn techniques to manage stress,
anxiety, depression, and relationship issues in ways that make sense in their lives. Treatment methods include
cognitive behavioral therapy and solution-focused strategies, among others. I make every effort to customize
treatment to suit each particular client and welcome your requests.
I have studied and worked with many issues including, but not limited to, relationship and family conflict, grief and loss,
stress, trauma, work-related issues, depression, and anxiety. I am very open to client feedback and will encourage you to
be active in the direction that your treatment will take.
Initials_____
By signing below, and initialing the previous page you are agreeing that you read the information above and on the
preceding pages, understand the contents, accept the terms, and have received a copy of my disclosure information.
You are also signing that you acknowledge receipt of my Notice of Privacy Practices (HIPAA). If you have any
questions now or in the future, please feel free to ask. I am available by voice mail at the phone number listed above
(unless my voice mail says otherwise). If you are in need of urgent assistance and I am not available, please call the
Crisis Clinic at (206) 461-3222.
I have read this document, and consent to therapy with Claire Bratt-Leal, MS, LMHCA, under the terms above.
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Client(s) Signature
Date
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Client/Parent/Guardian Signature
Date
In the case of divorce, I certify that I am the primary custodial parent of this child and have legal authority to sign. Initial___
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Therapist Signature
Date