Forms

If you would like to complete the paperwork digitally please email help@qcfamilycounseling.com to have a portal request sent to you.

If you have insurance we ask that you call your insurance company before the appointment and ask:

• If a pre-authorization is required
• If you are meeting a deductible
• The number of visits you are allowed 
• If you have a copay

Adult Form (Age 18 and Older)

Download Your Adult Form

Child Form (Age 18 and Under)

Download Your Child Form