Elly Wynia, LCSW, Individual and Couples Sex Therapist

Intake Forms:

Confidential Client Questionnaire

Each Individual coming in for therapy needs to fill this form out.  If you are a Couple please fill out this form separately.  

Riverwalk Associates intake forms - all

This form is mainly for INSURANCE and HIPPA and needs to be filled out whether coming in as a Couple or Individual. One form is all that is needed per Couple.


Imago Dialogue - steps ~ This will help you understand IMAGO and the mirroring better.

Childhood ~ Helping you to understand the inner work of your family of origin

Feeling Loved and Cared About ~ An assignment to be done as a Couple

My Relationship Vision ~ Couples Vision