Coastal Haven Counseling Forms Download Forms Here Adult Intake Forms Group Professional Disclosure Statement Form Adult Initial Clinical Assessment Form Copay Credit Card Authorization Form (Not needed for Medicaid Clients) 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 Client Demographic Info Form TeleHealth / TeleTherapy Informed Consent Form Interpreter Services Child Client Intake Forms Group Professional Disclosure Statement Form Child Initial Clinical Assessment Form Copay Credit Card Authorization Form (Not needed for Medicaid Clients) CONTACT US FOR MORE INFO OR TO SCHEDULE AN APPOINTMENT Name Email Address Message 1 + 12 = Submit Contact Us