Heal From Within Counseling

Set Appointment & Intake Paperwork

Set Appointment Now

ApptReminderForm1.doc (1590 downloads)

Notice-of-Privacy-Agreement.docx (1630 downloads)

Commitment-and-Consent-to-Treatment-rev-2008.doc (1524 downloads)

Couples-Intake-II.doc (1514 downloads)

Notice-of-Privacy-Practices-Counseling-Services-Jan-2011.doc (1390 downloads)

Click on the link above that says “Set Appoint Now” to fill out intake paperwork. In addition please read the Notice of Privacy and sign the Notice of Privacy Agreement.  Also print and  sign the consent to treatment and appointment reminder form. Please fill out and sign all necessary intake paperwork  before your first session.

If you are a couple filling out paperwork for the first time make sure both of you print a copy of the intake paperwork above, fill it out and bring it to your first appointment in addition to filling out information online at the “Set Appointment Now” link.

If you have any questions please let me know kelliegarzalmhc@gmail.com or 321-403-7036.




Kellie Garza LMHC, CST