773-332-7832
drkerzman@corespacecounseling.com

CoreSpace Counseling

Dr. Ryan Kerzman, Psy.D.

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Client Forms

If you are a new client of CoreSpace Counseling, please be sure to download and complete the following forms. Then, bring your completed forms with you to your first meeting/session. This will help ease you into therapy, and allow as much time to be spent on you as possible.

Client Contact Information Sheet

Client Intake

Limits of Confidentiality

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 for Release of Information

CoreSpace Counseling



Therapy Services

  • Individual Therapy
  • Couples Therapy
  • Family Therapy
  • Psychological Assessment
  • Pre-Surgical Bariatric Assessments

Private Client Services

  • Personalized Sessions
  • Walk and Talk Therapy
  • Personal and Professional Consultation
  • Professional and Executive Coaching
  • Performance Optimization
  • Speaking Engagements

Contact Info

773-332-7832
drkerzman@corespacecounseling.com

Find My Office

16335 S Harlem Ave
Suite 401
Tinley Park, IL 60477

Get in Touch with Me

If you have any questions or would like to schedule an appointment, please don't hesitate to contact us. We would love to work with you.

Contact Me »

Appointments »



CoreSpace Counseling


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