Therapy Forms for FCS

Available Forms

1. New Client Intake Form

For new clients, this form collects your personal information, contact details, and basic background to help your therapist understand your needs from the very first session.

At Focused Counseling Services, I strive to make starting or continuing your therapy as smooth as possible. This page provides easy access to the forms you’ll need before your appointment. Completing these forms ahead of time helps your sessions start efficiently and ensures we can focus on your mental health goals.

Intake Form

2. Consent & Confidentiality Forms

This form explains your rights, confidentiality policies, and the limits of counseling confidentiality. It ensures you understand and agree to the counseling process.

Confidentiality Policy
Letter of Informed Consent
Notice of HIPPA

3. Credit Card Payment Form

To streamline billing, this form gathers your payment information and preferred payment method.

Credit Card Auth.

4. Telehealth Agreement (if applicable)

If you’re using online counseling sessions, this form ensures you understand how telehealth works and agree to the process.

Informed Consent for Telehealth

5. Christian Counseling Agreement (if applicable)

If you are wanting counseling from a Christian worldview, this form ensures you understand how that works and agree to the process.

Consent to treat from Christian Worldview

How to Submit Your Form

Email: You may email completed PDF forms to john@focusedcounseling.org

In-Person: Bring your completed forms to your first appointment.

Need Help?

If you have questions about any of the forms or need assistance completing them, our friendly staff in Springfield, MO is here to help.

Call or Text me at: 417-501-5057
Email: john@focusedcounseling.org