Helpful Forms

If you will be using Health Insurance as part of you payment, please review and complete the Agape Counseling Center Forms and bring them to your first session.

If you will be paying by cash or check, please review and complete the following forms, bring them to your first session.

• Client Intake Form
• Limits of Confidentiality/Cancellation Policy Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

• Consent to Release Information Form

Client Intake Form

Confidentiality and Cancellation Policy

Consent to Release

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