Intake Paperwork

In an effort to make your experience the best it can be, we want to make sure you have enough time to fill out the intake paperwork for your first visit.  We have made our intake paperwork fillable on the computer so you can type up your responses when it is most convenient for you.  Simple fill out on your computer and print for your initial appointment.  If you'd prefer not to fill out on your computer, you can print the intake paperwork and fill it out by hand or you can let us know and we can mail the intake paperwork to the address you provide.

*If you are going to be seen for couples counseling, please fill out the adult intake paperwork for each of the adults in the relationship.  If you are going to be seen for family counseling, please fill out the paperwork for the "identified client".

If you have any questions during this process, we are here to help.  Give us a call 608-783-1452.


Adult Intake Paperwork

Child Intake Paperwork


For Your Review

Below is the paperwork for your review.  The therapist will touch on some of the main points in this paperwork at your first visit, so please review and ask any questions that you may have.  This file includes the Client Informed Consent, Privacy Policy, LWCFC Mission Statement and Grievance Procedure Brochure.  This paperwork can be downloaded and saved to your computer or printed and filed as you see appropriate.


Client Paperwork - Policies/Procedures


Blue Sheet

The Blue Sheet is a form that client's fill out at each of their appointments.  We have copies of the blue sheets in the waiting area, but wanted to provide you with the ability to fill this out at your convenience prior to your appointment if you'd prefer.  


Blue Sheet