Home
About
Contact and Location
Meet Our Counselors
New Client Forms
More

Home
About
Contact and Location
Meet Our Counselors
New Client Forms

New Client Forms

For Your Convenience

All our new client forms are fillable and printable.

For Adult Clients

New Adult Client Form (pdf)Download

Information For Client (pdf)Download

Credit Card Billing Form (pdf)Download

HIPAA Notice (pdf)Download

Informed Consent (pdf)Download

For Clients Under The Age of 18 (Signed by Guardian)

New Minor Client Form (pdf)Download

Consent To Treat A Minor (pdf)Download

Information For Client (pdf)Download

Credit Card Billing Form (pdf)Download

HIPAA Notice (pdf)Download

Informed Consent (pdf)Download

Copyright © 2022 The Place Within Counseling - All Rights Reserved.

All Associates and Trainees are under the supervision of licensed therapists Gary Henderson LMFT#7053 and Alexis Marson LMFT#80115

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