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Christ-Centered Counseling

African American Couple


Client Forms


Intake Form

New clients, complete the intake form & bring it to your first therapy session.




Helpful Forms

Release of Information Form

Life History Form

Your Information Your Rights Our Responsibilities




Current Client Survey - How are we doing?

Previous Client Survey - How'd we do?


Authorization to Disclose Information

If you would like us to coordinate care with another provider (For example, your psychiatrist, primary care physician, etc.) complete this form and authorize release of psychotherapy information

Authorization to Disclose Information Form