ADULTS

The following forms are for minor clients, seeking professional mental health counseling for themselves (aged 12-17) and/or for authorized parties seeking professional mental health counseling for minor clients (aged 17 and below). 

There are five (5) REQUIRED forms:

Demographic

Self Assessment

Informed Consent

Notice of Privacy Practices

Insurance Authorization

Directions for filling out and saving the documents:

1.  Download each document to your device

2.  Open one document at a time and complete

3.  After completing a document, go to:  File > Save As > PDF

4.  Change the name of the document to whatever you want

5.  Choose the location where you want to save the document

6.  Click:  Save

7.  Repeat this process for each form

Opening the forms directly from the website and filling them out without downloading/saving first may result in loss of entered information.  

Please download and save first, then open the documents to complete.

 If you are a minor at least 12 years old, but under the age of 18, seeking counseling for yourself, please fill out all the documents yourself.

If you are an authorizing party seeking counseling for a minor under the age of 18, please fill out all the documents yourself. 

Please fill out the documents completely.  

We will review these forms together and you are always welcome to ask any questions that may arise.

If you are having trouble opening, filling, or saving the files, please

Download Adobe Acrobat Reader DC