For Assessment & Evaluation: Online Evaluation Referral Form
Click here to Download it and complete via fax
For Psychotherapy and/or Wellness Counseling : Online Counseling Intake Form
Please note that while we use a secure server for all forms, all electronic communication has the risk of breach. Please feel free to download paper forms and submit via fax to 443-863-6262. Your use of our online forms includes your permission to use electronic comunication and your understanding of its risks.
For a detailed explanation of services, please download our brochure:
Click here to Download it and complete via fax
For Psychotherapy and/or Wellness Counseling : Online Counseling Intake Form
Please note that while we use a secure server for all forms, all electronic communication has the risk of breach. Please feel free to download paper forms and submit via fax to 443-863-6262. Your use of our online forms includes your permission to use electronic comunication and your understanding of its risks.
For a detailed explanation of services, please download our brochure: