Forms

Depending on the services you are receiving and how you are paying for your sessions, you will need to complete several of these forms before your first appointment.  Our scheduler will tell you which forms to complete and how to return them to your counselor.

Basic Policies of Wellspring

Client Information Form

Consent to Receive Counseling

Minor Consent to Receive Counseling

Consent for Release of Information

Financial Agreement

Credit Card Authorization Form

Sliding Scale Application

Sliding Scale Application with ROI