Christian Counseling

817-542-2305

Christian Counseling for Individuals, Marriage and Families

Forms

christian counseling
Tammy C. Desko, M.A., LPC

Abba Christian Counseling, PLLC

Colleyville


817-542-2305

Tammy@AbbaChristianCounseling.com

AbbaChristianCounseling.com

marriage counseling

Initial Assessment Forms:



Directions: 
You can print and bring the forms in for your first visit, or if you wish to fill out and submit forms via email.

Note: you must save .pdf to your computer before emailing


Required first visit forms:

Intake Form:
1_Intake_Forms.pdf
224.6 KB



Insurance Information (if using insurance):

Insurance_Information.pdf
46.9 KB



Acknowledgement of Receipt of Notice of Private Practices:
Notice_of_Privacy_Practices.pdf
43.3 KB



HIPPA Notice of Privacy Practices:
HIPAA.pdf
56.8 KB



Credit Card Authorization:
Credit_Card_Authorization.pdf
42.7 KB



Treatment Consent for Minor Child (if required):
Consent_for_Minor_Child.pdf
43.1 KB