Intake Forms for Adults

Let's get the paperwork out of the way...

All of the adult intake forms can be downloaded from this page. Please click on each link below, print out the corresponding intake form, complete the first two forms, and then bring them with you to your first appointment.

First, click on the following link for the Adult Intake Form:

• Adult Intake Form - Click Here

Second, click on the following link for the Consent to Treatment Form

• Consent for Treatment Form - Click Here

Third, read the LifeLine Counseling Policies and Procedures. This document provides you with important information about our practice and service to you. It does not need to be printed out or signed.

• LifeLine Counseling Policies and Procedures

Fourth, read the HIPAA notice regarding your rights to privacy under state and federal law. This document is provided to you in accordance with the law. It does not need to be printed out or signed.

• HIPAA Notice

Please remember to bring the Intake and Consent for Treatment forms to your first appointment.

Finally, no need to make a phone call - you can make your appointment online! Clicking the button below will take you to our secure online appointment system. Oh - and if something changes in your schedule, remember that your appointment confirmation email allows you to cancel or reschedule your appointment online too!

Please note that, while we do have evening appointments, they are typically filled and will not appear as available for online scheduling. You may request wait-listing for an evening appointment if you wish - we fill evening openings on a first-come basis. 

In the event of an emergency, do not use online appointment scheduling: contact 911.

Use of online appointment scheduling indicates that you understand and agree to the following terms:

1. The use of online appointment scheduling may not be confidential or secure although the site is secure, encrypted and monitored for security.  The onlne appointment system does not contain any health protected information.
2. Online appointments cannot be made for the same day.
3. Only one appointment can be scheduled at a time. 
4. We will notify you as soon as feasible if we cannot honor your appointment due to unforeseen scheduling conflicts or commitments.