Lifeline Counseling Center
PROFESSIONAL & PRACTICAL HELP

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  We help children, adults and families  

 

Intake Forms for Adults


Let's get the paperwork out of the way...

All of the adult intake forms can be downloaded from this page. Please click on each link below, print out the corresponding intake form, complete the first two forms, and then bring them with you to your first appointment.

First, click on the following link for the Adult Intake Form:

Second, click on the following link for the Consent to Treatment Form

Third, read the LifeLine Counseling Policies and Procedures. This document provides you with important information about our practice and service to you. It does not need to be printed out or signed.

Fourth, read the HIPAA notice regarding your rights to privacy under state and federal law. This document is provided to you in accordance with the law. It does not need to be printed out or signed.

Please remember to bring the Intake and Consent for Treatment forms to your first appointment.

Finally, please note: We charge a late cancellation/broken appointment fee of $35 per session when we are not given at least 24-hours notice cancelling an appointment.