Forms

 

For your convenience, our forms may be printed and completed prior to your initial consultation.  Please print and complete each form and bring them to your first session.

Forms are also available in the office for your use.  Please allow 15 minutes prior to your initial appointment time to complete these forms. 

Patient Data Form.pdf Patient Data Form.pdf
Size : 119.942 Kb
Type : pdf

Obtains patient information.

Consent for Treatment.pdf Consent for Treatment.pdf
Size : 760.076 Kb
Type : pdf

Provides consent to the therapist and Cornerstone Counseling Center to treat you.

Patient Contract.pdf Patient Contract.pdf
Size : 66.077 Kb
Type : pdf

Details many of Cornerstone Counseling Center’s policies about therapy.

Notice of Privacy Practices.pdf Notice of Privacy Practices.pdf
Size : 224.612 Kb
Type : pdf

Informational sheet for the client's reference.

Provides consent to Cornerstone Counseling Center to release information to outside parties such as insurance    companies, physicians or referral sources.  NO information about you or your treatment will be released without your consent.  If the client is under 14 years of age, please have a parent or guardian sign.

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