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LifeWorks Counseling Center

Therapy for Individuals, Children, Adolescents, & Families

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  • Hot Topics!
  • Online Video Counseling
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Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

  • Client Intake Form
  • Primary Care Physician Communication Form
  • Concerns, Medication Information, Allergies Sensitivities
  • Consent to Release Form
  • Client's Rights and Responsibilities
  • Client Information, Professional Services, and Business Policies Form
  • Additional Consent To Treat A Minor
  • Online Video Counseling Agreement
  • Consent for Treatment and Payment, Fee Schedule, and Financial Responsibility
  • HIPAA Acknowledgement Form


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Pottstown, PA Therapists
LifeWorks Counseling Center
933 N. Charlotte St.
Suite 1-D
Pottstown, PA 19464

(T) 610-323-4673(HOPE)
(F) 610-323-4672

[email protected]
[email protected]
[email protected]lifeworkscounselingcenter.net


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Schedule Appointment

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Helpful Forms

Click here to view and print forms for your appointment.

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