Client Forms

Client Forms

UNDER CONSTRUCTION
(Some Forms Available)

Initial Intake Visit

Clients will need to complete the following forms and questionnaires before they may be seen for their initial intake interview.  Clients are encouraged to download and complete these forms prior to coming for their initial session.

• Adult Intake Forms 
• Adult Symptom Screener
• DASS-42

• Child & Adolescent Intake Forms 
• Child Symptom Screener (Minors)
• DASS-42

Teletherapy Session Consent

• Teletherapy Consent Form 

• Automatic Payment Form

Financial Forms

• Automatic Payment Form

• Financial Agreement (Hardship)

Questionnaires & Screening Tools

• Screening For Childhood Anxiety Related Disorders (Child)
• Screening for Childhood Anxiety Related Disorders (Parent)

Automatic Payment Information

• Carroll Counseling Center – Severna Park
• Adult Symptom Screener
• Child Symptom Screener
• DASS-42
• Optional – Vanderbilt Parent Rating Scales / Vanderbilt Teacher Rating Scales
• Optional – MDQ
• Optional –