AWARENESS COUNSELING CENTER
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Below are the basic forms needed for your first counseling visit.  Your specific counselor may have other forms for you once you arrive at the office.

Please print and fill out the applicable forms and bring them to your visit. 

Policies/Insurance/Payment Forms (All Patients):

Patient Information
Consent to Treatment
Informed Confidentiality
Email/Text Consent
Credit Card Authorization Form
HIPAA Privacy Policy
Telehealth Informed Consent

Intake Forms (Adult Patients): 

Amen Adult Symptom Checklist
Adult Concerns Checklist
Intake Forms (Child/Adolescent Patients):

Amen Child/Teen Checklist
Amen Child Characteristics
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