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Intake Paperwork Packets 

*Note sections for specific counselor and choose the adult or 

minor paperwork packet option*

Katherine Arnold, LPC-S, LMFT-SC, CRFC

Adult Intake Packet for Katherine Arnold

The intake form provides me with information about you, your family, history, presenting problem, and associated symptoms.

Minor (under age 18) Intake Packet for Katherine Arnold

The intake form provides me with information about you, your family, history, presenting problem, and associated symptoms. ​  Please be advised that if you share custody of your adolescent, you will need to provide legal documentation that you have primary custody. Otherwise, both parents holding custody rights will be required to sign the Informed Consent prior to treatment.

Couples Consent Release

Information obtained from an adult client individually may NOT be shared with anyone without written consent.  Information may be released ONLY with the client’s spouse or other family members with the client’s written permission.  Clients may refuse to provide written permission to waive confidentiality rights between or among each other. Please be advised that withholding information from each other during couple or family therapy could impede or even prevent a positive outcome to therapy.

Melissa Carson MEd, LPC, NCC

Adult Intake Packet for Melissa Carson

The intake form provides me with information about you, your family, history, presenting problem, and associated symptoms.

Agreement of Confidentiality with Teenage Client

This form creates an agreement of confidentiality to promote trust between therapist and adolescent while allowing exemptions to be clearly defined by Parent/Guardian. 

Minor (under age 18) Intake Packet for Melissa Carson

The intake form provides me with information about you, your family, history, presenting problem, and associated symptoms. ​  Please be advised that if you share custody of your child/adolescent, you will need to provide legal documentation that you have primary custody. Otherwise, both parents holding custody rights will be required to sign the Informed Consent prior to treatment.

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