Intake Paperwork

This paperwork is required for your consent. The preferred method is to use the link for the Client Portal (below).

(1) Select I’m a New Client. (2) Select Service Diagnostic Assessment/New Client. (3) Select Request an Appointment. This allows you to view the schedule and request an appointment. (4) After you select the date and time you will be asked to enter your contact information. (5) Appointment requests will be confirmed by the practice and directions how to proceed with the required intake paperwork.

Allied Counseling offers a sliding fee scale. The rates for services are adjusted based on the ability to pay. The application is based on the federal poverty guidelines, family size, and income.

Attention: Do not complete # 7 Consent to Treat a Minor if you are not requesting services for a minor. Do not complete #8 Relationship Policy if you are not seeking family therapy. #14. The Sliding Fee Scale Application is optional. If this paperwork hasn’t been completed prior to your first appointment, your therapist will review the forms with you and obtain your consent. Please, be advised that doing the paperwork at the time of your appointment extends the duration of the appointment.

If you would like to preview the paperwork and/or fill it out, outside of the client portal click on each button below