...Working together to reach the summit.

Forms

Prior to coming in for your first appointment, please fill out these required forms.  This will help save time during your first visit.

 

 

 

 

Client Registration
Summit Counseling REG FORM.pdf
Adobe Acrobat document [4.6 KB]
Consent for Counseling Services
Summit Counseling consent.pdf
Adobe Acrobat document [118.9 KB]
Adult intake and registration form
Adult Intake Information.pdf
Adobe Acrobat document [217.0 KB]
Child/Adolescent intake registration
CHILD AND ADOLESCENT INTAKE FORM.pdf
Adobe Acrobat document [124.0 KB]
Fee disclosure
SC Fees.pdf
Adobe Acrobat document [384.1 KB]
Personal Health Information Policies/Procedures
Notice of Policies and Practices to Prot[...]
Adobe Acrobat document [234.4 KB]
Billing information
SC Credit Card info.pdf
Adobe Acrobat document [241.5 KB]
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Summit Counseling, PLLC