Forms

Thank you for your care in completing and reviewing this information prior to your first session. Please thoroughly review the Information for Prospective Clients included in this intake packet. We realize this document is lengthy. We are required to include all of this information by the mandates of federal privacy legislation, certain insurance requirements, and our ethical and state guidelines.

New Clients

*Please complete the ‘Agreement for Parents’ form for minor clients with parents not residing in one home.



Returning Clients

Other Forms

Checklist for your first appointment:


  • Completed forms
    • Adult Client Information or
    • Child & Adolescent Client Information
    • Agreement for Parents : This form is required for minors not residing in one home with both parents.
  • All insurance cards if you will be using health care benefits.
  • Co-Pay or Payment. Checks may be made payable to Counseling Associates.
  • Relevant school and health records.
  • Documentation of parenting plan in case of minor not residing in one home with both parents.
  • Completed Authorization for Release of Information for any individuals or agencies with whom you wish our office to coordinate services (e.g. school, medical providers). Also, please complete this form for any previous counselors with whom you or your child has worked.