All Forms 2017-10-20T15:32:31+00:00

Transformed Hearts Counseling Center, Inc. has many forms available below for new and existing clients, as well as therapists and those seeking to pursue speaking engagements.

Get Adobe ReaderAll documents are available in PDF format. If you do not have Adobe Acrobat installed, please click here to obtain a free adobe Reader.


COUPLE’S CONFERENCE FORM


For couples attending the Annual Couple’s Conference

If you are interested in attending the upcoming Annual Couple’s Conference in November 2016, please complete and submit the following form or visit the website to register online.

 

GROUP MEMBER FORMS


For all new group members

All new group members are required to complete a New Group Member Participation Form as well as a Disclosure Statement. To access the forms, please click on the links below.

2017 New Group Member Men’s Packet

2017 New Group Member Women’s Packet

Please complete the front and back portion of the form along with the Disclosure Statement.


INTENSIVE FORMS


For individuals & couples participating in an intensive

All new intensive clients are required to complete the New Client Information Form and Disclosure Statement.  You are also welcome to complete the Intensive Insurance Statement Request Form, if needed. To access these forms, please click on the links below.

2017 New Client Forms Packet


NEW CLIENT FORMS


For individuals, couples, & families

All new clients are required to complete the New Client Information Form, as well as the Disclosure Statement Form. To access these forms, please click on the links below:

2017 New Client Forms Packet


POLYGRAPH FORMS


For polygraph clientele

If you are interested in pursuing a polygraph examination, please review the following Polygraph Information Packet. To schedule and proceed with a polygraph examination, please complete the Polygraph Form listed below.

2017 Polygraph Form


RELEASE OF INFORMATION FORM


For clients to request records

This form is utilized for clients to provide or receive authorization to release personal and confidential information.  To access this form, please click on the link below.

2016 Release of Information Form


SPEAKER RESERVATION FORM


For speaking seminars/conferences

Cory speaks at various events throughout the year.  If you are interested in reserving a date or a speaking engagement, please complete the Speaking Engagement Form. To access this form, please click on the link below.

2016 Speaking Engagement Form


SUPERVISION FORM


For therapists in need of supervision
This form is utilized for individuals who are seeking mental health supervision services.

Save

Save

Save

Save