Restoration  Family Counseling Center

FORMS

FORM FOR COUPLES & FAMILIES



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InsuranceAccepted By
Partnership, Beacon 
Therapists and Associates


Family Counseling Center

 A complete packet of forms is required for each person participating in session before the session can begin.

Please complete forms, print single sided, sign, and bring to your initial session. 


ADULTS                                                                    MINORS

             Marriage and Family Therapist INTERN  I
 FEES
Initial Intake 
  $110
Clinical Session
 $105
Missed Appointment Fee (Without 24 hours notice)
$ 60
Written Reports (50 minutes)
$105


Licensed Marriage and Family Therapist
FEES
Initial Intake 
  $150
Clinical Session
 $120
Missed Appointment Fee (Without 24 hours notice)
$ 60
Written Reports (50 minutes)
$150