Please answer the following questions to help your counselor provide beneficial referrals at your intake.
They are receiving counseling services from
Please note, this does not authorize us to contact these providers or release information to them. If you would like for us to contact them, please let your counselor know and a consent can be completed.
Individual is to answer the follow questions truthfully and honestly. Answers will not affect your treatment with STAR Council.
Do you live with someone who has any of the following symptoms?