Belaire Counseling Services
Christine Belaire, Ph.D.
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FAQ
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Spiritual & Religious Values
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The Learning Curve
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The Abraham Group
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Below are links to the forms you will need for your first counseling session.  Please print and complete the necessary forms and bring them to your counseling session. 

  • Adults should complete the Client Information Form-Adult. 
  • When bringing children, complete the Client Information Form-Child. 
  • Couples should each complete the Client Information Form-Adult. 
  • Each person should complete the Declaration Statement and HIPPA Privacy Notice . 
  • The Consent to Release Information should be completed if Dr. Belaire needs records from another professional (i.e. counselor, doctor, teacher, attorney, etc...). 
Initial Counseling Session
Client Information Form - Adult To be completed individually by all adults. Teenagers ages 15 to 18 can complete in place of child form.
Client Information Form - Child To be completed by children ages 5-15. Parents help if necessary.
Declaration Statement To be read and signed by all adults.
HIPAA Privacy Notice To be read by all adults.
Consent to Release Information Completed as needed for records or exchange of information between professionals.
Separation and Divorce Recovery Group
Separation and Divorce Recovery Group

|Belaire Counseling Services| |Christine Belaire, Ph.D.| |Services| |FAQ| |Forms| |Articles| |Spiritual & Religious Values| |Upcoming Events| |Book Reviews| |New Books and Products| |The Learning Curve| |Workshops| |Internet Links| |Contact Us| |Directions| |The Abraham Group| |BR Events|


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