Wellness Counseling Center, LLC

Forms

Forms

For your convenience, you can complete the required documents on Therapy Appointment 2.0. If you are unable to do this, please arrive to your initial appointment 15 minutes early to complete the forms in the office.

Please follow this link to Therapy Appointment 2.0 for Holly Darton

Please follow this link to Therapy Appointment 2.0 for Elena EarlĀ 

Please follow this link to Therapy Appointment 2.0 for Marcy Fanello-Diaz

Please follow this link to Therapy Appointment 2.0 for Bedford Hines

Please follow this link to Therapy Appointment 2.0 for Sally Hudson

Please follow this link to Therapy Appointment 2.0 for Michelle Van Thiel

Please follow this link to Therapy Appointment 2.0 for Elizabeth Walker

  • Use the username and password provided by our office staff to log-in and access your account
  • When completing the Biographical Information Form – it cannot be saved if partially completed so make sure you have enough time to complete the form once you begin. It will take about 15 minutes to completeE.
  • If the identified client is a minor, a parent or guardian should assist where necessary.
  • If more than one person will be attending the session, have each person fill out their own form. The same log in will be used for all attendees.

Thank you and we look forward to seeing you soon.

If you are having problems logging in to your account, the forms can be printed by clicking below.

1. Biographical Information Sheet

2. Notice of Privacy Practices

3. Informed Consent and Client Consent Form

4. Teletherapy Informed Consent Form

5. In-Person Covid-19 Informed Consent Form

6. Your Rights and Protections Against Surprise Medical Bills