Our Forms
In order to streamline the intake process, we have some forms below. Please click the forms to complete your request. A therapist will contact you to within 24-48hours. 

She's Counseling Intake Form

Case Worker Referral Form

Parenting, Protective Clarification, Anger Management, AOD 

Targeted Case Management

 Case manager to assist with Mental Health Concerns, Substance Use, Developmental Disabilities, Chronic Medical Conditions, Housing Instability, Employment/Education Needs, Legal Issues

School Referral Form

In School Counseling and Behavior modification,

In-school autism services, ABA therapy (RBT)

Medication Management 

Intake Form

Most Medicaid-Medicare-BCBS-AETNA-Tricare-United Health Care-