Helpful Forms

If you're a first-time client, please review and complete the following forms, bring them to your first session.

Client Intake Form
Limits of Confidentiality/Cancellation Policy Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

Consent to Release Information Form

Client Intake Form

Confidentiality and Cancellation Policy

Consent to Release

Note: To download Adobe Acrobat Reader for free, click here .

Dr. Charlena Sears
(973) 755-1882

Montclair Center
Psychotherapy
460 Bloomfield Ave
Suite 209
Montclair , NJ 07042
[email protected]

Dr. Sears provides counseling and psychotherapy for clients of all ages from a variety of backgrounds and intersections.
Specialty areas include anxiety, depression, stress, trauma and messy life transitions.

Proudly serving Montclair, New York, Livingston, The Oranges, Maplewood, Bloomfield, The Caldwells, Newark, Verona, Bergen County, Union County, Passaic County, and their surrounding communities.