Ph: 225-387-2287      Fax: 225-383-2722

Forms

Please select the appropriate form(s), print them out, fill them out and bring them to your first session. If you can’t print them, come 30 minutes early for your first session.
Thank you !

FORMS FOR:

INTAKE FORMS FOR ADULTS AND ADOLESCENTS 16 & OVER

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ALL FORMS LISTED ARE REQUIRED AT THE FIRST APPOINTMENT

NOTE:  For COUPLE counseling, EACH person needs to fill out their own set of forms

CounselorAdultsChild/Adolescent 
Adams, DeeDee Adams New Client Formsn/a
Alleman, JulieJulie Alleman New Client FormsJulie Adolescent Intake
Bond, MelissaMelissa Bond New Client FormsMelissa Bond Child/Adolescent Intake Forms
Easterly, SarahSarah Easterly New Client Formsn/a
Gilbert, JoelJoel Gilbert New Client FormsJoel Child/Adolescent Intake
Kadair, SherrySherry Kadair New Client Formsn/a
McKowen, ErinErin McKowen New Client FormsErin Adolescent Intake
Sneed, KenKen Sneed New Client Formsn/a

Other Forms:  If you need to have your counselor share information with someone else, you’ll need to print, complete, and sign this form:

Authorization for Release/Exchange of Confidential Information Form

IMPORTANT:
Click HERE if you want to use your insurance benefits