4094 Main Street, Suite 202
Hillard, Ohio 43026


Please complete the Client Information Form for each person coming in. Please complete the Child-Adolescent Information Form for anyone under 18. 12 and under should be done by a parent, 13 and older should fill it out themselves. You will also find an Informed Consent, a Teletherapy Consent and a statement of Privacy Notices.  All consents need signed before the first session.

Client Information Form (Printable only) or (Fillable) *** Bring To First Visit
Informed consent for Teletherapy or (Fillable) *** Fax this form to 614-777-6375
Child Adolescent Information Form *** Bring To First Visit under 18 years old
Informed Consent or (Fillable) *** Bring To First Visit
Notice Of Privacy Practices
Receipt of Privacy Practices or (Fillable) *** Bring To First Visit
Release of Information
Agreement for Parents