Forms

Intake Form – Adult

Client Self-Assessment

Consent for Clinical Treatment Form

Read Only:  Notice of Privacy Practices

Intake Form – Minor

Client Self-Assessment

Agreement for Minor Children

Consent for Clinical Treatment Form-Minor

Read Only:  Notice of Privacy Practices

If you need to authorize your clinician to have access to give or receive your health information, Authorization to Release Information

If you would like to keep a credit or debit card on file, Card Authorization

Church Assistance Program – Authorization Form

Church Assistance Program – Release Form