Centrapeutic Counseling
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  • APPOINTMENT
  • FORMS
  • PAYMENT
  • CONTACT
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  • ABOUT
  • SERVICES
  • APPOINTMENT
  • FORMS
  • PAYMENT
  • CONTACT
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Forms

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

Client Paperwork

Counseling Intake Form (either Individual or Family)

Comprehensive Assessment Form

Relationship Assessment Form

Consent Release Form

Authorization for Release of Confidential Information Form

Confidentiality & Cancellation Policy

Telehealth Services Consent

Contact Information

  • Irving, TX
  • (469) 759-3777
  • [email protected]
  • Mon & Wed 10:00 pm – 7:00 pm
  • Sat 9:00 am -12:00 pm

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Privacy

Please review HIPPA Link to PDF document privacy practices requirements.

Business Information

EIN # 87-3960302
NPI #1417621079

Important

In case of emergency, please call 911 or go to your nearest emergency room.

Links & Resources

Find additional mental health information and resources.

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National Suicide Prevention Lifeline 1-800-273-8255