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The Summit Therapy Center

(330) 345-8450

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(330) 345-8450

The Summit Therapy Center
  • Home
  • Meet Our Therapists
  • Forms
  • Distance Counseling
  • Contact
  • About

Forms for New Clients

Click on the name of the form below to download it

New clients should download and print the New Client Data, Patient Financial Policy, and Informed Consent Agreement forms out to the best of their ability and sign prior to their first session. If there will be any distance counseling, then clients should include the Distance Counseling form as well.

If there are any questions about what to write in any part of the form, clients should skip those areas and ask when they come in.

New Client Data

Informed Consent Agreement

Informed Consent Agreement

 Required information to become an established client. 

New Client

Informed Consent Agreement

Informed Consent Agreement

Informed Consent Agreement

 Form that defines the agreement between patient and counselor. 

Informed Consent

Financial Policy Document

Financial Policy Document

Financial Policy Document

 Agreement to establish how the therapist will be paid for services. 

Financial Policy

Distance Counseling

Financial Policy Document

Financial Policy Document

 Form for existing clients to complete and bring or send to Summit to enroll.  

Distance Counseling

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