Forms for Couples Therapy

Counseling West
4419 Van Nuys Blvd., Suite 310
Sherman Oaks, CA 91403

(818) 990-9898  

Fax: 818 783 2243
Your communication is private
and confidential.
Hours: Mon- Fri, 8am to 9pm
               Sat, 8am-6pm

For Training Program inquiries

We are conveniently located in
Sherman Oaks, close to the 101
and 405 freeways.

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Forms for Couples Therapy

We'd like to spend your appointment time getting to know you, not having you filling out paperwork.  For that reason, we ask that you please complete the following forms prior to your arrival.  If you are unable to do so, please arrive 15 minutes prior to your appointment, and advise your counselor so they may have the forms ready for you to fill out in our waiting room.
Please complete the adult intake form and the consent forms for each person.

Adult Intake Form

Consent to Treatment Form

Telemedicine Consent Form