AFFILIATED COUNSELING CENTER NEW CLIENT INTAKE PACKETS

Once the intake packets are downloaded and filled out, 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

CHILD INTAKE PACKET 12 YEARS OLD AND UNDER

Download Packet

ADULT INTAKE PACKET 13 YEARS OLD AND ABOVE

Download Packet
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