The Episcopal Counseling Center

Client Intake Packet (Includes Client Intake Information, Financial Disclosure Form, Health Insurance Claim Form, and Authorization to Release Information)

Client Intake Information (pdf)

Financial Disclosure Form

Pre-Marriage Intake Information

Pre-Marital Personal and Social History

Health Insurance Claim Form (pdf)

Child and Family Data Summary (pdf)

Patient's Bill of Rights and Responsibilities

Authorization to Release Information (pdf)

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