Forms
New Clients
For Your Review- Please review prior to first appointment
The Policies and Procedures paperwork is for your review. The therapist will touch on some of the main points in this paperwork at your first visit, so please review and ask any questions that you may have. This file includes the Informed Consent to Treatment, Fees and Insurance Information, Privacy Practice Notice, Client Rights and Grievance Procedure Brochure, and the LWCFC Mission Statement. This paperwork can be downloaded and saved to your computer or printed and filed as you see appropriate.
Intake Paperwork- Please fill out prior to first appointment
In an effort to make your experience the best it can be, we want to make sure you have enough time to fill out the intake paperwork for your first visit. We have made our intake paperwork fillable on the computer so you can type up your responses when it is most convenient for you. Simply fill out on your computer and print for your initial appointment. If you'd prefer not to fill out on your computer, you can print the intake paperwork and fill it out by hand or you can let us know and we can mail the intake paperwork to the address you provide.
*If you are going to be seen for marriage counseling, please fill out the adult intake paperwork for each of the adults in the relationship. If you are going to be seen for family counseling, please fill out the paperwork for the "identified client".
If you have any questions during this process, we are here to help. Give us a call 608-783-1452.
Please fill out and bring to your first appointment:
Telehealth Forms and related information can be found here:
Other Forms: