top of page

Please complete the appropriate form for your specific clinician prior to your first appointment:

​

*Nancy De Haas, LPC-S:

Adult intake packet for psychotherapy 

Child intake packet for psychotherapy

Couples intake packet for psychotherapy

Nancy De Haas's Release of Information form

Church Scholarship Client Agreement form

Pastoral Scholarship form

Good Faith Estimate

*To connect with Nancy using telehealth technology for your regularly scheduled appointment please visit: www.doxy.me/dehaas

​

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session. 

​​​

​

*Heather Roberts, LICSW, RPT:

Adult intake packet for psychotherapy

Child intake packet for psychotherapy

Request/Authorization for Release of Information form

Pastoral Scholarship form

Good Faith Estimate

​

*To connect with Heather using telehealth technology for your regularly scheduled appointment please visit: www.doxy.me/heatherrobertslicsw

​

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session.

​

​

*Lesley Neely, MA, ALC, NCC:

Child intake packet for psychotherapy

Pastoral Scholarship form

Good Faith Estimate

​

*To connect with Lesley using telehealth technology for your regularly scheduled appointment please visit: https://doxy.me/lesleyneely

​

Please read and be prepared to discuss the Informed Consent for Telehealth Services prior to the first session. 

​​​

​

*Angie McDonald, MA, Pastoral Counseling

Certified NeurOptimal® Trainer

Pastoral Care Adult Intake Packet

Pastoral Care Couples Intake Packet

NeurOptimal® Neurofeedback Intake 

​

​

*Caleb Dykes, MA, ALC:

Adult intake packet for psychotherapy

Child intake packet for psychotherapy

Good Faith Estimate

Release of Information

​

​

FORMS

bottom of page