Belaire Counseling Services
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Empowering people to move forward

Counseling for adults, adolescents, children, couples, and families in Baton Rouge, Louisiana
Schedule Appointment

Couples Forms
Instructions:

Click on the links below to print each form.  Complete the forms and bring them to your first counseling session.
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  1. Adult Information Form - To be completed by all adults attending counseling
  2. Declaration Statement - To be signed and initialed by all adults attending counseling
  3. Couples Release of Information - To be signed by all adults attending couples counseling.
  4. 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)
  5. HIPAA Privacy Notice Signature Form – To be signed by all adults attending counseling

Services


Counseling Adults                             Communication
Counseling Children                          Spirituality
​Counseling Adolescents                   ​Child Protection
Counseling Couples                           Custody Evaluations
Counseling Families


Company


About                                             ​Make a Payment
Belaire Counseling                        ​​Blog
Dr. Belaire                                       ​​Parfait Publishing

Support


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FAQ
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  • 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