Counseling Center
Forms
Adult New Client Form
This form is to be completed by new adult clients over the age of 18. This information is for you to provide some basic history of yourself and why your seeking counseling from us. This information is confidential.
Adult New Client Authorization Form
This form is to be completed by new adult clients over the age of 18. This will determine your fee and give us permission to provide professional counsel to you. Couples seeking counseling must complete this from as well. This information is confidential.
Adult Couples Form
This form is to be completed by couples over the age of 18. This information is for you to provide some basic history of you and your partner or spouse and why your seeking counseling from us. This information is confidential.
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. This must be completed for each child. This information is for you to provide some basic history of your child and why your seeking counseling from us. This information is confidential.
Child/Adolescent Authorization Form
This form is to be completed by the parents/legal guardians of clients who are under the age of 18. This must be completed for each child. This will determine your fee and give us permission to provide professional counsel to you. This information is confidential.
Professional Disclosure and Qualifications
For Clients of Melissa Altman