Clarity Psychological Services, LLC
{ Call for a free phone consultation: 412.628.2818 }
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  • Meet the Therapists
    • Pascual Chen, Psy.D.
    • John Hartline, LCSW
    • Emily Lunt, LSW
    • Grant Fisher, MA, NCC
    • Jamie Diaz, MA, NCC, PLPC
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    • FAQS
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FORMS

All clients are to complete the Client Information Form, Informed Consent, and Notice of Privacy Practice (NPP). You have the opportunity to read the Informed Consent and Notice of Privacy Practice (NPP) prior to your first appointment by clicking and downloading below. I will provide these forms to you to sign and read upon your arrival or you can print them and bring them to our appointment to save time.  Please read below to know which questionnaires to complete in addition to the aforementioned forms.

Client Information Form
File Size: 73 kb
File Type: pdf
Download File

Informed Consent
File Size: 103 kb
File Type: pdf
Download File

Notice of Privacy Practice
File Size: 142 kb
File Type: pdf
Download File


  • Clients 18 and older receiving individual therapy are to complete the Adult Questionnaire.
  • Clients ages 12 to 17 are to complete the Adolescent Questionnaire and the parents/guardians are to complete the Parent Questionnaire. 
  • Clients receiving couples therapy or whose chief compliant is marital/relational distress are to complete both the Couples Questionnaire and the Adult Questionnaire.
  • All clients are to complete the DASS 42.

Please download and complete the questionnaires prior to your arrival and bring the questionnaire(s) to your appointment.

You also have the option to complete all of the paperwork online. By providing your email address when you make your first appointment, you will receive an email from Clarity Psychological Services with a link to your personal client portal where you can complete all necessary documents. If you lost the link and need to finish completing your forms online go here to get access to it again: https://claritypsych.clientsecure.me

Forms for Adult Clients
Clarity Adult Questionnaire
File Size: 93 kb
File Type: pdf
Download File

DASS 42
File Size: 68 kb
File Type: pdf
Download File

Forms for Adolescents and Parents
Clarity Adolescent Questionnaire
File Size: 65 kb
File Type: pdf
Download File

Clarity Parent Questionnaire
File Size: 71 kb
File Type: pdf
Download File

DASS 42
File Size: 68 kb
File Type: pdf
Download File

Forms for Couples
Clarity Couples Questionnaire
File Size: 58 kb
File Type: pdf
Download File

Clarity Adult Questionnaire
File Size: 91 kb
File Type: pdf
Download File

DASS 42
File Size: 68 kb
File Type: pdf
Download File


 Psychological Services, LLC
6200 Brooktree Road Suite 110
Wexford, PA 15090
Phone: 412-628-2818
Email: drchen@claritypsych.com
Schedule Appointment
Serving the North Hills area, including Wexford, Butler, Beaver, Gibsonia, Ross, Warrendale, Cranberry, Pine-Richland, McCandless, Mars, Allison Park, Franklin Park, Hampton, and Pittsburgh
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