FORMS

Paperwork can be completed at the first meeting (please arrive 10 minutes early if you chose this option), or you may download, print, and complete in advance.

 

Instructions:

1. All clients must complete the Intake Form

2. All clients must sign the Informed Consent Form (the individual signing must be 19 years or older). Please note that teens older than age 15 must sign in addition to the parent signature. 

3. Release of Information is only needed if you would like us to share information with other providers or individuals involved in treatment. 

 

Please don't hesitate to contact us if you have any questions about this paperwork. 

 

For Natalie's Clients

Intake Form and Informed Consent- Adult

Intake Form and Informed Consent- Youth

Release of Information

For Amy's Clients

Intake Form and Informed Consent- Adult

Intake Form and Informed Consent- Youth

Release of Information

For Chris' Clients

Intake Form and Informed Consent- Adult

Intake Form and Informed Consent- Youth

Release of Information

Give us a call today! 6044544516 

200-22471 Lougheed Hwy, Maple Ridge, BC, V2X2T8

604.454.4516

© 2018 Revive Counselling Services. All Rights Reserved

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