Intake Forms

If you're a new client, please print, complete and bring the following forms to your first therapy session. Adults:

 

Minors:

 

 

If you would like us to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Note: To download Adobe Acrobat Reader for free, click here.  

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Location

Availability

Monday:

11:00 am-8:00 pm

Tuesday:

3:00 am-9:00 pm

Wednesday:

10:00 am-8:00 pm

Thursday:

10:00 am-7:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

616 392-7695

Fax: 616 392-6955

Main Location:
Nederveld Assoc. Bldg.
347 Hoover Blvd., Suite A
Holland, MI 49423

Second Location:
217 Sunrise Dr.
Holland, MI 49423

[email protected]