I think some of the suggestions of how to word it are great - and I think having something from her is important for you, so asking would be a good idea. I wish I had done that when I moved, all I have is some official letters in my medical notes, and I miss the 2 main people who were involved in my care so much still.

I hope all goes well with your move, and that you find a new therapist you can work with soon.