Call (208) 359-4840 Fax (208) 359-9010
INTAKE forms
INTAKE FORMS
Email your completed Intake and Consent forms to mail@centerpointcounseling.com and then call us at (208) 359-4840 to check availability.
*If no providers are taking new clients, you may be required to be put on a waitlist until a provider is available.
You may fill them out online (no printer required) when you have Adobe Reader (available here) or print them out and take a pic of your forms & email them
pAYMENT RESPONSIBILITY form
PAYMENT RESPONSIBILITY FORM - 3RD PARTY PAYER SIGNATURE FORM
If there's another person or group that would like to pay for your Video Therapy sessions, please have them sign and email us the following form:
CCS 3rd Party Payer Form (pdf)
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