• Adult Client Information Form

    Please take your time to fully fill out this form. It is quite detailed and can take up to 15-20 minutes. The information that you provide allows our clinicians to begin your treatment with as much information as possible-- saving you time in your initial session (and ultimately saving you money).
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  • Client History




  • Family History

  • Current Relationship History

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  • Past Relationship History

  • Should be Empty: