Karen Bloch, MFT
Therapy for Adults, Children and Couples
Karen Bloch, MFT
(858) 455-1355
3252 Holiday Court
Suite 227
La Jolla, California 92037
info@karenblochmft.com
Helpful Forms

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

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

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:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form

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