AFFILIATED COUNSELING CENTER CLIENT INTAKE PACKETS

We now offer online registration through our patient portal. To set up your patient portal account and start the process of becoming a new client, please call our office at 920-887-8751, and we will assist in creating your account.

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If you chose to download our intake packets below, please return them to us via email, fax, mail or drop them off at our clinic. We will then contact you to complete an intake summary and go over the scheduling process.

Email: officemanager@affiliatedcounseling.net

Fax: 920-887-3977

Mail: 1807 N. Center Street, Suite 204, Beaver Dam, WI 53916

Office Hours: M-F 8:30 to 5:00