Patient Forms

Intake Packet

Open Form

Protected Health Information Disclosure

Open Form

Insurance Card Upload

Open Form

Name Change Acknowledgment

Open Form

Treatment Plan Consent and Agreement

Open Form

Payment Authorization Form

Open Form

Spanish Intake Documents/Haga clic aquí para ver nuestros documentos en español.

Open Form

Client Authorization for Student Observation/ Participation

Open Form

Consent and Services Agreement - Group Therapy

Open Form

Coordination of Care (COC)

Open Form

South Charlotte NC

Online Counseling by Video, Phone & In-Person
GET STARTED – 704.503.8196

Cotswold - Charlotte NC

Online Counseling by Video, Phone & In-Person
GET STARTED – 704.264.2973

South Asheville NC

Online Counseling by Video, Phone & In-Person

GET STARTED – 828.333.9320

Central Asheville NC

Online Counseling by Video, Phone & In-Person

GET STARTED – 828.333.9320

Book Online

Online Counseling by Video, Phone & In-Person
Convenient Online Scheduling