Southeast Institute
For Group and Family Therapy
Gary Peterson M.D. Intake Forms
Balancing, centering, and calming is often the initial focus in our therapy. People come for relief of tension issues, mood and impulse problems and body sensation struggles. The treatment frame is often from a developmental perspective. Overreactive triggering experiences can be addressed through developing self-soothing skills and by weakening the early foundations of currently disturbing reactions.
To set up an intake appointment, you can call 919-929-1171, and we will have a brief phone conversation to confirm a good fit between your requirements and my skills. If you are currently in therapy, we will coordinate the initial treatment plan with your therapist. You will be asked to request that your therapist contact me so that I can find out how my services will fit into the treatment plan.
For over 20 years I have been treating patients experiencing a wide variety of issues and teaching groundbreaking psychotherapy methods to clinicians. This rustic setting is in the hills of Edwards Mountain just north of the Governors Club at a few miles southeast of Chapel Hill.
If you are a new patient, for password protected forms please call SEI for a password. (919-929-1171)
New Adult Patients, please download and complete the following forms:
New Children and Adolescent Patients, please download and complete the following forms: (For adolescents age 15 and above, please ask them to independently complete the Adult History form above)
Other Checklists
- Edelbrock Rating Scale
- ADHD Symptom Check list
- CDC
- Symptom Check list
- A-DES
- Release of Information
- Directions to Southeast Institute
- Collaborative Treatment Agreement
