Client Forms

Please print and complete the following forms and bring them with you to your first appointment:

Permission, Understanding and Acknowledgement
Informed Consent
Client Information
Card Authorization
Initial Assessments Part 1
Initial Assessments Part 2
Medication List
Adult Intake Assessment (patients aged 18 and over)
Adolescent Intake Assessment (patients under the age of 18)

Please read through the information in the following and save or print for your records:

Notice of Privacy Practices
What to Expect from You Licensed Professional Counselor
Limits of Confidentiality
Cancellation Policy