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Hadley Counseling

Hadley Counseling

An exciting journey of healing and self discovery.

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    • Intake Form
    • Client Consent to Treatment
    • Privacy Practices
    • Release of Information Form

Intake Form


Personal Information

I give permission to be contacted at these numbers

Emergency Contact

I give permission to contact this person at these numbers

Presenting reason(s) for seeking services: (check any that apply)

Reasons for Seeking Therapy

Development

Are there special, unusual and traumatic or abuse circumstances that affected your development?

Medications

Counseling/Treatment History

Legal

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I have received a copy of Elizabeth Hadley’s Professional Disclosure Statement and have had it explained to me.

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