Forms — Crane Counseling, LLC

Client Intake Forms

Please complete all of the following INTAKE forms for your Initial intake appointment. You are welcome to print, complete and bring with you - or scan and email to cindy@cranecounselingllc.com or via text at 301.370.9794.

Client History Form

Mood Inventory Form

Informed Consent Form

Credit Card Authorization Form

Teletherapy/Audio Consent Form

Medicare Opt-Out Contract Form: (Clients 65 yr + with Medicare)

Authorization for Release of Information

Client Forms

Client Intake Forms

Contact Cindy