Client Intake Forms
Please download and complete these forms before your first session. This helps us provide you with the best possible care.
Client Intake Forms
Complete intake documentation required for new clients before the first therapy session.
Instructions
Download the intake forms document by clicking the button below
Complete all required fields in the document
Bring the completed forms to your first session or email them to acc.counselor@gmail.com
If you have any questions, please call us at (945) 234-3637
File: form.docx
Privacy & Confidentiality
All information you provide in these forms is confidential and protected under HIPAA regulations. Your privacy and security are our top priorities.
Office Hours
Monday - Saturday: By appointment only
typically 8:00 AM – 8:00 PM
Get In Touch
Simply fill out the brief fields below and Dennis Patrick Smith, LPC will be in touch with you soon, usually within one business day. This form is safe, private, and completely free.