For the convenience of clients, we have made intake and other forms available for completion on-line prior to their visit with our office. (Of course, if it is more convenient, you can arrange to come to the office early and complete the forms by hand before your session.) Scroll down to see all forms.

Click on the form title (blue) and it will appear in a form which you can complete from your keyboard. Use your mouse to click on box or button to indicate your answer or fill in the blanks with text. When you have completed a form, you can print it out and bring it with you on your first visit or you can save it to your computer and then send an email with your last name in the subject line to FamilyCounselingCenter@aol.com with the form(s) attached.

When you are finished with a form, you can use the back button to return to this page.

Please allow a few moments after you click on title for the file to load.

All clients are asked to complete Family Counseling Center Registration and Fee Agreement. Don’t worry if you don’t have all the insurance information, just fill in as much as you can. If you are not covered by insurance or EAP benefits, just leave insurance information bank.

If you are an individual, please complete the FCC Adult Checklist of Concerns. If you are coming in as a couple, please each complete the checklist.

If you are bringing a child for counseling, complete the adult checklist above as it applies to the child and then please have one or both parents complete the FCC Child Checklist of Characteristics If the child is a teenager, have them complete the Adult Checklist of Concerns and you as parent(s) still complete the Child Checklist of Characteristics.

 

 

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