Balanced Life Therapy

New Client Form # 1

Client Counselling Intake Form

If you're a new client, please complete this form and bring it with you to your first peer counselling session.

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New Client Form # 2

Limits of Confidentiality/Counselling Cancellation Policy

If you're a new client, please complete this form and bring it with you to your first peer counselling session.

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Authorization Form

Authorization to Disclose Information

If you would like Balanced Life Therapy to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of counselling information.

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