Colorado Center For Healing And Change

Awareness Is Power. Change Is Possible.

Forms

* Please note our NEW Aurora office location, we are now located at:

13791 E Rice Place Aurora, CO 80015

Pleas feel free to down load the appropriate forms before you come in for your inital session.   Otherwise, you are welcome to fill them out at the time of your first appointment.  If you are wanting to go through insurance and we have an insurance slot open for you, please fill out a release form as well.   Please note, the counseling forms are listed first, the Ticket To Work forms for SSDI and SSI clients are listed second.       Thank You!

Counseling Forms

ADULT INTAKE FORM

MARITAL INTAKE FORM (each person needs to fill out one form)

ADOLESCENT INTAKE FORM

CHILD INTAKE FORM

AUTHORIZATION TO RELEASE INFORMATION

CONSENT FOR COUNSELING OF MINORS

Ticket to Work Forms

Supportive Employment Plan Application

Self-Starter Employment Plan Application

Payment Request Form


Aurora Counseling and Therapy Services