Forms

Intake Forms

Please print, fill out, sign, and bring these forms to your first appointment. If you prefer, you may fax them to us at 248-645-0562. (If you choose to email the forms, please note that email is not considered to be a confidential medium of communication.)

Individual and Couples Therapy:

Couples: Each of you should print, fill out, sign, and bring your own copy of those forms.

Welcome and Information

Informed Consent Agreement

Notice of Privacy Practices (HIPAA)

New Client Intake

Payment Policy

Financial Counseling:

Welcome and Information

Informed Consent Agreement

Notice of Privacy Practices (HIPAA)

Financial Intake

Debt Worksheet

Personal Spending Plan

Payment Policy