Please fill out this form whether you are receiving individual, family, or couples counseling. For couples counseling, both partners may fill out the form.
Child/Adolescent Intake Form
Parents and Guardians must complete this form, on behalf of any minors who are to receive counseling.
If you are using FL Blue Insurance or are working with an intern and planning to use Aetna insurance, please fill out this form prior to your intake appointment.
