Forms

Client Information Update

Records Release Form

Other Forms:

Client Forms:

ADULT Intake Forms

Please print and complete forms 1-5 below and bring them with you on your appointment. Review forms 6 and 7. You may print these for your records if you wish. It may take a moment for each file to load depending on your computer speed.

Child Intake Info

PCP Note

Current Problems

Developmental History

Concerns/ Family History

Informed Consent

CHILD Intake Forms

Please print and complete forms 1-7 below and bring them with you on your appointment. Review forms 8 and 9. You may print these for your records if you wish. It may take a moment for each file to load depending on your computer speed.

Privacy Practices A

Privacy Practices B

Financial Info

Arizona Family

Resource Counseling Center

Arizona Family Counseling - AZ Family Resource Counseling Center

Acknowledgement to Treat