Phone: 704-841-9454
Fax: 866-834-1817
Email: hello@changewithinme.com
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A Change Within, PLLC

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Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Client Intake Form

Information Sheet

Limits of Confidentiality

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

Sarah DeMaison, MSW, LCSW

A Change Within, PLLC



704-841-9454
866-834-1817
hello@changewithinme.com

250 N Trade St STE 203
Matthews, NC 28105

Business Hours
Monday-Thursday 9am-4pm
Friday 9am-11am

Sarah DeMaison, MSW, LCSW

A Change Within, PLLC

704-841-9454
hello@changewithinme.com

250 N Trade St STE 203
Matthews, NC 28105

Business Hours
Monday-Thursday 9am-4pm
Friday 9am-11am

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