Forms

Please print the appropriate paperwork as well as your counselors professional disclosure below.  We ask that you fill these out in advance and bring these forms and your insurance card to your scheduled appointment. Please note: All NO SHOW and late cancellation appointments will be billed at the full rate. These fees are not billable to your insurance.  Fees must be paid before your appointment can be rescheduled. If you are a first time client and give us less than 24 hours notice about rescheduling your appointment, we will not reschedule you again in our office.

Adult Intake Forms (pdf)

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Parent Guardian Form (pdf)

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Child Intake Forms (pdf)

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Disclosures

Brandi Hedges-Hubert PDS (pdf)

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Connie Jones PDS (pdf)

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Eugene Naughton PDS (pdf)

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Jessica Beckman PDS (pdf)

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Jamie Crockett PDS (pdf)

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Jessie DeussingPDS (pdf)

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Jennifer Kiszley-Bressler PDS (pdf)

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Jamian Newton PDS (pdf)

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J. Scott Young PDS (pdf)

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Karen Elliot PDS (pdf)

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Katherine Glenn PDS (pdf)

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Kristen Gregory Patterson PDS (pdf)

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Traci Collins PDS (pdf)

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Molly Casebere PDS (pdf)

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Sara DeHart-Young PDS (pdf)

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Isaiah Collins PDS (pdf)

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