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Safe Harbor Christian Counseling
CHICAGO - FORMS

Authorization to Release Information
Consent for Treatment of a Minor
Credit Card Authorization Form
Policies and Procedures
Privacy Notice
Progress Note Form
Sliding Scale Form

Client Intake Form
Counselor Disclosure Form
New Client Appointment Form
Additional Policies and Procedures
Privacy Notice Acknowledgment (HIPPA)
Safe Harbor Financial & Scheduling Policy
Uniform Treatment Plan Form

Take our Marriage Check Up
Provides a tangible assessment of your marriage
View More Information and Schedule

"For Women Only"
October 23, 2010 - Fairfax, VA, & Lanham, MD

Copyright 2007-2010. Safe Harbor Christian Counseling. Site Map
Counselors providing Christian-Based, Clinically Sound Counseling since 1996.
Offices in Baltimore, DC, Maryland (MD), Virginia (VA), South Central Pennsylvania (PA), Philadelphia Metro, Delaware (DE), Connecticut (CT), and Chicago.

Safe Harbor Christian CounselingCHICAGO - FORMS

Safe Harbor Christian Counseling
CHICAGO - FORMS