Intake Forms for New Telehealth Clients

Thank you for choosing ABC Counseling! We look forward to your first appointment with us. This page contains all the steps that need to be completed prior to your first session.

In order to provide the best level of care to you, it is important to complete all of the forms below AT LEAST 72 HOURS PRIOR TO YOUR FIRST SESSION. If the forms are not completed by this time, it may result in your appointment being rescheduled.

If you have any questions or are having difficulties completing any of the forms listed below, please contact our office at 321-446-2113.

Step 1A: Complete Intake Form

Please click on the button below with your counselor’s name on it. It will take you to our web portal to complete the intake form. You will need the username and password provided to you during your phone call with us when scheduling. After you have completed this step, please move onto the next one.

Step 1B: For Child Clients

Please complete the following forms. A minor consent form is required from each parent and a youth agreement form is required for children ages 13-18. The youth agreement form must be completed and signed by the child.

Step 2: Review and Sign Consent Form/Privacy Practices

Please read the consent form and privacy practices, then sign the form.

Step 3: Credit Card Authorization

We ask for the Credit Card Authorization form when the card is not present. For your security, your Credit Card Information is not filled out online; however, you can agree to the terms and can relay this information over the phone.

Step 4: Intake Forms Finished!

Once you have completed all the steps above, you are ready for your initial session. If you have any questions please feel free to call our office. Thank you for completing the forms and we look forward to working with you!

Step 5: Start Your Telehealth Session

Please click on the button below that corresponds with your new counselor. It will take you to their telehealth page. Once on the page, enter your name into the text box, then it will ask for permission to access your microphone & camera. Click “Allow” or “Accept” (based on your browser), then you will be in the waiting room. Your counselor will bring you into the room momentarily.