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Client Forms

If you are new to therapy or counseling with Pathways to Healing Counseling, LLC please be sure to fill out the following forms, and bring them to your first session. This will help ease you into therapy, and allow as much time as possible to be spent focusing on you.

Counseling Relationship & Informed Consent

Client Intake

Couples Informed Consent (Couples only)

Limits of Confidentiality

Authorization for Release of Information

Name *

E-mail *

Phone

Preferred Session Times *

Type of Session Preference *

Location Preference *

How did you hear about us? *

Specify

Comment or Message

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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

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