Leyla Dim, MS, LPC Integrative Counseling and Clinical Hypnosis for Adults, Adolescents & Couples in Cody Wyoming

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Leyla Dim
307-587-6288
Phoenix Rising Counseling, PC
1001 14th St.
Cody, WY 82414
ldim@wyomingtherapist.com
Helpful Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Psychotherapy Intake Form
  • Limits of Confidentiality/Therapy Cancellation Policy

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Client Psychotherapy Intake Form
Limits of Confidentiality/Therapy Cancellation Policy
Authorization to Disclose Information Form

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