Download forms . . .
We recommend you download and complete appropriate forms prior to your appointment. This will not only save you time at our office, but will allow you the opportunity to closely examine the forms and formulate any questions you may have.
These are in PDF format, and you will need a recent version of Adobe’s Acrobat Reader. If you don’t have this software, you may download it from Adobe by clicking <here>
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If you are coming in for counseling, download and complete the following forms (couples: one form for each person): #2, 3, 6, 12, 13
If you are coming in for counseling for your minor child, download and complete the following forms: #2, 3, 6, 8, 10, 11
If you are coming in for a First Offender Substance Abuse Evaluation, download and complete the following forms: #3, 5, 6
If you are coming in for a Multiple Offender Substance Abuse Evaluation, download and complete the following forms: #3, 4, 5, 6, 14, 15, 16, 17
If you are coming in for a SAP evaluation, complete form #9 and forward to us prior to your first appointment.
If you would like to be considered for our Low Cost Clinic, complete the appropriate forms above, plus the Application for Low Cost Clinic (form #1)
If you are planning on using your insurance as full or partial payment for your counseling, complete the appropriate forms above, plus form #18 (“For Those With Insurance”)
If you would like for us to charge your credit card for counseling more than once time, please complete form #7 (“Credit Card Preauthorization”)
Click on form to download it . . .
1-Application for Low Cost Clinic.pdf
2-Info&Agrmt-Counseling Clients
4-Multiple Offender Evaluation Contract
7-Credit Card Payment Consent Form
20-Registration Confirmation.pdf
