The Counseling Center Of Western New York Psychotherapy for Individuals, Couples and Families

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The Center
(716) 833-0415
CounselingWNY@gmail.com
Helpful Forms

If you're a first-time client, please review and complete the following forms and bring them to your first session.

  • Client Intake Form
  • Limits of Confidentiality/Cancellation Policy Form
  • Privacy Practices Form (HIPPA)

If you would like us to coordinate care with another provider (for example, your psychiatrist, endocrinologist, etc.), complete this form:

  • Consent to Release Information Form

 

Client Intake Form  
Confidentiality and Cancellation Policy  
Consent to Release  
Privacy Practices Form (HIPPA)  



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