Intake Forms

Please download and print out the intake form that corresponds to your provider.  Please bring completed contact information and signed consent forms to your first appointment. The remaining pages are for you to keep for your records. Feel free to contact us if you have any questions about filling out the forms.

Dr. Eric Morse: click here to download (.pdf) 

Dr. Michelle Joshua: click here to download (.pdf)

Dr. Tye Hunt-Harrison: click here to download (.pdf)

Dr. Heidi Green: click here to download (.pdf)

Dr. Jeff Krepps: click here to download (.pdf)

Keisha Hinton, LCSW, LCAS: click here to download (.pdf)

Yelena Gidenko, LPC: click here to download adult form (.docx); click here to download child form (.docx)

Dr. Katherine Walker: click here to download Intake form (.pdf); click here to download Agreement (.pdf)

Dr. Christine Dittmer: click here to download Intake form (.doc)

Dr. Stephanie Marko:  click here to download Intake form (.doc)

Joseph Rabiega, MA, LPC:  click here to download Intake form (.pdf)