Documents

We do our best to make each and every visit you have with us as productive as possible. Part of this effort includes making all of our documents available to you so that you can have them filled out before coming to your first session. Please take a few minutes before you come in and complete the appropriate documents.

Please select and print the correct packet below:

HPC Adult Intake Packet – This packet must be competed by anybody over the age of 18.

HPC Couple Intake Packet – This packet must be completed by those who are wanting to engage in counseling with a spouse, partner, or significant other.

HPC Adolescent Intake Packet – This packet is for all minors between the ages of 12 and 18.  The adolescent should complete the Adolescent Information form.  A parent or guardian must sign the fees and consent form and the HIPPA form.

HPC Child Intake Packet – This packet is for all minors below the age of 12.

Instructions for completing forms:

Intake form– This form provides us with important information about you, your spouse, partner, or significant other, or your child and adolescent. If form is for a child or adolescent, please make sure you provide the client or adolescent’s name and information.  The parent or guardian should sign the consent at the bottom.

Client Information form– The information on this form gives us a head start on getting to know you, and helping you with your troubles.

HPC HIPAA– The HIPAA form explains how your information is kept and released. Please put on this form anybody that you would like for us to be able to release information to, or obtain information from. Examples might be a doctor, lawyer, step-parent, school, or other relative.  If you do not wish for us to release or obtain information from anybody, please leave form blank and sign at the bottom.

HPC Fees and Client Consent– This form explains fees associated with counseling and contains information about compliance with the Health Insurance Portability and Accountability Act of the United States government.

Additional information.

Love Language Quiz – This quiz helps us learn more about how you express and interpret love.