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Forms

Here are forms used at the Counseling Center.  For a first appointment, you may print out the Questionnaire Form and the Signature Form and complete them to bring with you.

If you wish for confidential information to be shared with another party, you may print out and complete and sign the Release of Information Form.  It needs to be sent or faxed to the Counseling Center for us to release information to the identified person or professional office.  The release of information form may be filled out and signed by the client, and then faxed to another or previous doctor office which allows them to provide the Counseling Center with your records.

First Appointment Signature Page

First Appointment Questionnaire

Release of Information Form

HIPAA Notice of Privacy Practices