Intake Forms
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Hobby & Recreation Group
Remember the Joy!Counseling and Consultation
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For all clients: Family Information Form - Basic
Information, including Name, Address, People in home
and Insurance Information.
For all clients:
Information about Services, Fees, and Confidentiality.
Informs you about my code of ethics, your rights, limits
of confidentiality, and fee agreement.
If child is primary client:
Child History form
Parent Questionnaire
If adult is primary client:
Adult History form
Optional: How Vulnerable Are You to Stress?
If you would like to give me permission to talk to another
professional on your behalf.
Release of Information
Information, including Name, Address, People in home
and Insurance Information.
For all clients:
Information about Services, Fees, and Confidentiality.
Informs you about my code of ethics, your rights, limits
of confidentiality, and fee agreement.
If child is primary client:
Child History form
Parent Questionnaire
If adult is primary client:
Adult History form
Optional: How Vulnerable Are You to Stress?
If you would like to give me permission to talk to another
professional on your behalf.
Release of Information
Ready to come to
your first session?
Call or email to
arrange your
appointment.
Download the
appropriate forms
and bring with you!
your first session?
Call or email to
arrange your
appointment.
Download the
appropriate forms
and bring with you!