Coastal Haven Counseling Forms

Download Forms Here

Adult Intake Forms

Client Demographic Info Form

Group Professional Disclosure Statement Form

Adult Initial Clinical Assessment Form

TeleHealth/TeleTherapy Consent Form

TeleHealth / TeleTherapy Informed Consent Form

Couples Counseling Questionnaire

Also fill out adult forms to the left.

Couples Intake Questionnaire Form

Additional Forms

Authorization To Release Form

CHC Privacy Practices Info

BCBS & Self Pay Missed Appt Policy & Copay Credit Card Authorization Form

Child Client Intake Forms

Client Demographic Info Form

Group Professional Disclosure Statement Form

Child Initial Clinical Assessment Form

CONTACT US FOR MORE INFO OR TO SCHEDULE AN APPOINTMENT