Forms, Fees and Information
fax Counseling Associates at 540-662-2874
In order to facilitate the best use of our time at your first appointment, you may view and download the CA Intake form, Insurance Information Form, the Financial Agreement and other valuable information about fees and methods of paying for counseling. To use the forms, click on the links below. Open .doc files in MSWord, and .pdf files in Adobe Reader. If a .pdf opens in MSWord, click on "open in a different viewer" and select "Adobe".
If you schedule an appointment you may download the forms to your own computer to fill out and print in advance of our first meeting. You may type directly into intake forms. Alternatively, please allow a few minutes before your appointment time to complete these forms at the office.
There are several ways to pay for counseling services. Please take a few minutes to read about your options at Paying for Counseling. We have also provided a list of fees as of October, 2016. Fees are subject to change.
Thank you for your assistance.
Intake and financial forms for Geoff only:
Free online genogram; right click to open in new tab: Complete and print without saving information which you may bring to your session.
If you like you may register and save your family tree on their site, otherwise you will lose the information you have entered.
Additional information that may be important and useful for all clients.
NOTE: Some files may take a while to download if using a non-broadband connection.
Dr. Rick Hansen's weekly emails and Wise Brain Bulletin.
The newsletter suggests a simple practice each week that may bring you more joy, more fulfilling relationships, and more peace of mind and heart. The Wise Brain Bulletin is sent to you six times a year, both for free..
Young Living Essential Oils.
Integrating modern technology with ancient wisdom for powerful plant extracts promoting balance, health and wellness.
Link to purchase Serotonin Spray for immediate effect. (hard to find)
PureRXO nutritional supplements. The Healthy Living Shop.
Click here for suggested nutritional supplements.
Click here to order supplements; enter your email address and in the provider box type "counselingassociatespc"!
The Healthy Living Shop.