Belaire Counseling Services
Home
About
Belaire Counseling
Dr. Belaire
Parfait Publishing
Services
Adults
Children
Adolescents
Couples
Family
Communication
Spirituality
Custody Evaluations
BASE Child Safety
Forms
Adults
Children and Adolescents
Couples
Custody Evaluations
Additional Forms
Contact
Blog
FAQ
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Schedule Appointment
Adult Forms
Instructions:
Click on the links below to print each form. Complete the forms and bring them to your first counseling session.
Adult
Information
Form
- To be completed by all adults attending counseling
Declaration Statement
- To be signed
and initialed
by all adults attending counseling
HIPAA Privacy Notice
- To be reviewed by all adults attending counseling (this is to be kept for your records and does not need to be brought to the counseling session)
HIPAA Privacy Notice
Signature Form
–
To be signed by all adults attending counseling
Home
About
Belaire Counseling
Dr. Belaire
Parfait Publishing
Services
Adults
Children
Adolescents
Couples
Family
Communication
Spirituality
Custody Evaluations
BASE Child Safety
Forms
Adults
Children and Adolescents
Couples
Custody Evaluations
Additional Forms
Contact
Blog
FAQ
Make a payment