Adolescent and Family Counseling Intake Forms

For your convenience, I have provided some of my forms electronically.

Forms for Clients Under Age 18

The Counselor Disclosure Statement for Under 18 can be read prior to the first session and printed at home if you like. Please note that both the youth and parent/guardian should read and sign this form.

The form below takes about 15 to 20 minutes to fill out and must be printed and completed by the parent or guardian. Please note that this form can not be filled out digitally. If you have problems downloading the form let me know and we will make other arrangements.

Under 18 Client Information Form

Forms for Adult Clients

The Counselor Disclosure Statement for Adults can be read prior to the first session and printed at home if you like.

The form below takes about 15 to 20 minutes to fill out and must be printed and completed by hand. If you have problems downloading the form, let me know and we will make other arrangements.

Adult Client Information Form