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Substance Abuse
Home
About Us
Services
Client Forms
Substance Abuse
FORMS
Please print out the following forms (1-6),fill them out, and sign them
prior
to your first appointment
. Bring them with you, and we can discuss any questions you may have at that appointment.
To download the Counseling Form Packet in its entirety:
agape_counseling_packet.docx
File Size:
32 kb
File Type:
docx
Download File
Individual Forms:
(1) Counseling Intake Form
/uploads/6/9/5/8/69580925/agape_counseling_services_intake_form.docx
(2) Client Coaching Consent Form
/uploads/6/9/5/8/69580925/agape_coaching_consent.docx
(3) Notice of Privacy Practices (HIPAA)
/uploads/6/9/5/8/69580925/agapeprivacynotice.docx
(4) Release of Information
/uploads/6/9/5/8/69580925/agape_release_of_information.docx
(5) Professional Disclosure Statement
/uploads/6/9/5/8/69580925/agapeprofessionaldisclosure.docx
(6) Informed Consent for Assessment and Treatment
/uploads/6/9/5/8/69580925/agapeinformedconsentandtreatment.docx