Thank you for taking an interest in the Counseling Center at Heritage! By completing these forms before your first appointment, it will save you time in our waiting room and maximize time with your therapist. In cases of joint legal custody, the consent form for a child (13 and under), must be completed by both parents. In cases of sole custody, the legal parent must bring a copy of the custody order.
|Consent Form (to be signed by all parents and legal guardians)
Adult Biographical Information (For Clients 17+ Only)
Adolescent Biographical Information (For Clients 11+ Only)
Child Biographical Information(For Clients Under 10 Only)
Weekly Caregiver Report (Every week for children under 10)
Parent Consultation Form (Once a month for children under 10)