Associated Counseling Professionals
2255 S. 132 St. - Suite 200 - Omaha, NE
Habit control appointment? Skip the long forms! Special forms for
smoking cessation clients -- please download form 1 and form 2.
Note: you can skip the 6 page form above.
Need Adobe Reader? Download it -- free -- by clicking here
|
When you open and print the forms file in
Adobe Acrobat Reader, make sure you
adjust your printer settings to
"auto-rotate", as seen in the illustration.
Phone: 402-334-1122
FAX: 402-334-8171
Choose the intake form based on the age of the person receiving services.
|
Download - print - fill out these forms before your first session.
|
Age 19 and above
|
Birth to 18
|
Adult forms
|
Child-Teen Forms
|
|
Mike Streeter, APRN - offers assessments for medications used to help with mood, anxiety, or depression
|
Mike's Intake Forms
|
|