(917) 900-1177
myquietplacepc@gmail.com

2381 Hylan Blvd, LL, Suite #2
Staten Island, NY 10306
NPAP Building
40 West 13th Street
New York, NY 10011

You Can Find me On Yelp

My Quiet Place

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Client Forms

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

Client Information Sheet

Limits of Confidentiality Adults

Limits of Confidentiality Children

If would like to have your sessions collaborated with another mental health advisor, simply fill out the next form, and we can discuss the necessary arrangements.

Authorization for Release of Information

My Quiet Place

Marina Krugolets, LMHC, LPC

(917) 900-1177
myquietplacepc@gmail.com

2381 Hylan Blvd, LL, Suite #2
Staten Island, NY 10306

40 West 13th Street
New York, NY 10011


View My Posts From:


  • ‘Help Me Figure Myself Out’: The Paved Road to the Adolescent Mind
  • Our Kids’ Desire to Remain Little, Our Own Efforts Force Them to Grow Up Fast

thera-LINK: secure online therapy

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My Quiet Place

Marina Krugolets, LMHC, LPC
Psychotherapy for Adults, Families, & Couples
Office visits available in Staten Island, NY
 
Phone: (917) 900-1177
Email: myquietplacepc@gmail.com
 
2381 Hylan Blvd, LL, Suite #2
Staten Island, NY 10306

 
40 West 13th Street
New York, NY 10011

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