Client Forms
Make an appointment
You can conveniently make an initial appointment by:
- completing this form with your information
- calling us at 330-972-6822
Initial paperwork
Prior to your first appointment, all clients are required to complete initial paperwork.
HIPAA
Notice of privacy practices at the Clinic for Individual and Family Counseling. Effective now this notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.