Counseling Intake Form

First step to
something better.

As you start on your path toward counseling, we will gather various types of information from you. From insurance information to personal history, our intake specialists will work closely with you to make sure we get everything we need. You can get ahead by completing the intake form below.

Once we have your completed this 4 part intake form, we will contact you for the next steps. You can also click here and download the referral form.

This is a four part intake form. Once completed you will be contacted by Family Innovation’s intake specialist to schedule your first session. Please have your insurance information available.