If you are obtaining therapy for your child, please print and fill out the following forms:

Intake Form – Minor  (Use if client is under 18 years of age)

Consent for Clinical Treatment 

HIPAA

If you are obtaining therapy for yourself and/or adult family member, please print and fill out the following forms:

Intake Form – Adult 

Consent for Clinical Treatment 

HIPAA 

If you need to allow us to have permission to discuss your situation with another person and/or agency, please print and fill out the following form

Consent To Release Information 

If you would like for us to use a debit/credit/HSA/flexible spending account card as your payment option, please print and bring to your first session:

Credit Card Authorization  

If you are a pastor or church leader and authorizing a church member access to our services, please print and fill out the following form:

CAP Authorization Form