Social Butterfly Counseling

Clinical Forms

Please fill out the following forms and forward to your clinician prior to your first session.

Adult Intake Form

Child/Adolescent Intake (for Child)

Child/Adolescent Intake (for Parent)

Credit Card Authorization Form

Informed Consent for Telehealth

Limits of Confidentiality

Cancellation Policy

Phone Consultation Policy

Notice of Precautions (COVID-19)

In-Person Consent Form

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