Counseling Center Forms

New Client Authorization Form

This form is to be completed by all new clients, both child and adult, in conjunction with the new client form. This form authorizes the counselor to communicate with other individuals (doctors, counselors, family members etc.) should your specific situation merit this communication.

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Adult New Client Form

This form is to be completed by all new clients over the age of 18. If more than one party is participating in the counseling session (ex: marriage counseling, couples’ counseling, and family therapy etc.), then one completed form PER PERSON is required. (See child/Adolescent New Client Form if under 18 years of age)

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Child/Adolescent New Client Form

This form is to be completed by the parents/legal guardians of clients who are under the age of 18. If more than one party is participating in the counseling session, such as in family or group therapy, one competed form PER PERSON is required. (See Adult New Client Form if 18 years of age or older)

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Sliding Scale Info Sheet

This document is informational and offers insight into anticipated session fees. This document serves as an informational piece for our present and potential clients.

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Pre-Marital New Client Form

This form is to be completed by new clients coming in for pre-marital counseling services. The standard Adult New Client form need not be completed if services are only for pre-marital counseling.

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