Forms

After scheduling your first appointment, please complete both of the following steps to be prepared for your initial appointment. Completing these steps beforehand will allow more time for you to speak with your therapist about the issues  that bring you to counseling.

  • Step 1: Please COMPLETE the New Client Information Form. You will fill out this form online.  After clicking the “submit” button on this form, you will be automatically redirected to a page where you will read our Consent, Disclosure, & Policies Form and our HIPAA Policy (Step 2). You will sign the Consent, Disclosure, and Policies Form when you attend your first session.

 


List of All CCC Forms:

  • Consent, Disclosure, & Policies Form: All adults will sign this form at their first therapy session. Please note that each adult participating in therapy will need to sign a separate form.
  • HIPAA Policy: All clients should read CCC’s policy of compliance with Federal Requirements Regarding Confidentiality.
  • Authorization to Release Information Form: If you need your therapist to share any information with an outside party, please fill out this form online here.
  • CCC Credit Card Authorization Form: If you are a parent/legal guardian of a minor who will be attending therapy, and if you will not be present to pay for each session, please print and complete this form and have your child/teen bring it to their therapy session.