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    info@openedhearttherapy.com | 617-942-1470

  • Opened Heart Therapy

    • Home
    • Our Team
      • Matthew Munich, LICSW, PhD
      • Melissa Ming Foynes, PhD
    • Services
      • Assessments
      • Therapy
        • Therapy for Perinatal Mental Health Difficulties
        • Trauma, Loss, and Unexpected Complications in Mothers, Infants, and Children
        • Mindfulness-Based Therapy
        • Dialectical Behavior Therapy (DBT)
        • Trauma-Related Therapy
          • Prolonged Exposure Therapy (PE)
          • Dialectical Behavior Therapy and Prolonged Exposure (DBT PE)
          • Cognitive Processing Therapy (CPT)
          • Skills Training in Affective & Interpersonal Regulation – STAIR
          • Cognitive-Behavioral Conjoint Therapy for Posttraumatic Stress Disorder (CBCT)
        • Interpersonal Psychotherapy (IPT)
        • Cognitive Behavioral Therapy (CBT)
        • Multi-Family Support
      • Consultation & Supervision
    • Getting Started
      • Rates & Insurance
      • Client Forms
      • Appointment Request
    • Resources
      • Client Portal
      • Apps, Podcasts, Blogs
      • Physical Health Links
      • Mental Health Links
      • Recent News
    • Contact
    • Publications
      • Dr. Munich
      • Dr. Foynes

    Client Forms

    Once you have scheduled your appointment, please complete these forms and bring them with you to your first session:

    1) Intake Form
    2) Notice of Privacy Practices (to be read and kept for your records)

    If you would like to grant permission for us to speak with anyone else about your care, please fill out the following:

    Authorization for Release of Information

    Please let us know about any questions you may have.

    Opened Heart Therapy

    201 Providence Road
    Chapel Hill, NC 27514

    5003 Southpark Drive
    Suite 240
    Durham NC, 27713

    info@openedhearttherapy.com
    617-942-1470
    Opened Heart Therapy | 617-942-1470 | info@openedhearttherapy.com
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