Wayne Chan, M.A., MFT
Therapy for Individuals, Couples, & Families
Wayne Chan
(949) 910-5035
27401 Los Altos
Suite 275
Mission Viejo, CA 92691
waynechanmft@yahoo.com
Helpful Forms

If you're a new client, please complete the appropriate forms (adult or child/adolescent intake) and bring them to your first session.

  • Adult Client Intake Form
  • Child and Adolescent Intake Form
  • Limits of Confidentiality/Cancellation Policy Form

 

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

  • Consent to Release Information Form

 


Client Intake Form  
Confidentiality and Cancellation Policy  
Consent to Release  
Child and Adolescent Intake Form  

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

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