• Solution Counseling Center
  • Counselors
    • Leza Ries
    • Jodi Kneer
    • Shannon Erickson
    • Angela Brown
    • Rochelle Ignatz
    • Tara Bjorkman
    • Elaina O’Brien
    • Vianey Pelaez
    • Lesley Norris
    • Samantha Petroshius-Crocker
    • Ashlie Cleaver
    • Laura Gooding
    • Amy Ferguson
    • Ester Czovek, MFT
    • Michaela Kearney
    • Maria Boggs
  • About Us
    • Career Opportunities
    • Office Photos
    • Resources & Support
  • Patient Forms
  • Contact Us
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Solution Counseling
  • Solution Counseling Center
  • Counselors
    • Leza Ries
    • Jodi Kneer
    • Shannon Erickson
    • Angela Brown
    • Rochelle Ignatz
    • Tara Bjorkman
    • Elaina O’Brien
    • Vianey Pelaez
    • Lesley Norris
    • Samantha Petroshius-Crocker
    • Ashlie Cleaver
    • Laura Gooding
    • Amy Ferguson
    • Ester Czovek, MFT
    • Michaela Kearney
    • Maria Boggs
  • About Us
    • Career Opportunities
    • Office Photos
    • Resources & Support
  • Patient Forms
  • Contact Us

Patient Forms

In order to save time on the day of your visit, please print and complete the forms below and bring them along with you to your first appointment.

  • New Patient Info
  • Medical History
  • Service Agreement
  • No Show – Clearwater (No Show or Cancellation) – Clearwater office
  • No Show – Trinity (No Show or Cancellation) – Trinity office
  • Notice of Privacy Practices
  • Authorization to Release Clearwater
  • Authorization to Release Trinity
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