Internship and Consultation Forms

If you are a registered mental health counselor intern or registered marriage and family therapy intern and are seeking clinical supervision, please complete the two forms below:

Intern Data Sheet (Online Version(PDF)

Supervision Agreement (Online Version(PDF)

Supervision Log

Credit/Debit Card Authorization Form (optional)
 

If you are a mental health professional seeking consultation, please complete the form below:

Consultation Consent Form (Online Version)(PDF) 

 

Contact Us

Locations

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Office Hours of Operation

Monday

9:30 am - 5:00 pm

Tuesday

9:30 am - 5:00 pm

Wednesday

9:30 am - 5:00 pm

Thursday

9:30 am - 5:00 pm

Friday

9:30 am - 5:00 pm

Saturday

Closed

Sunday

Closed

Monday
9:30 am - 5:00 pm
Tuesday
9:30 am - 5:00 pm
Wednesday
9:30 am - 5:00 pm
Thursday
9:30 am - 5:00 pm
Friday
9:30 am - 5:00 pm
Saturday
Closed
Sunday
Closed
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WHERE IS YOUR PAIN?

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