New client forms are the first step to starting your journey with your counselor. They are an important tool to give you information about your rights and responsibilities in regard to counseling, as well as give your counselor important information to get to know you.
We want to make this step as easy as possible, below you will find an accessible e-sign version of each of our forms, please complete all forms and consents that apply for each counseling participant. When you are done- we will be able to input your paperwork into your chart no scanning, faxing, or emailing required. However, if you prefer a pen on paper PDF version is available for download at the very bottom for you to print and return.
If you have any questions about your paperwork or which ones apply to you and your family please call Lindsey at 432-557-1775
For individuals 18 years and older participating in individual counseling or couples counseling.
For children and adolescents participating in individual counseling or play therapy, to be completed by legal guardians.
Required for anyone participating in counseling at Affinity offices.
Required for anyone participating in online counseling.
Required only for clients of Cameron Dumas.
This form allows Affinity providers and staff to communicate with any listed individual.
Use this form to update, make changes, or add new or secondary insurance.
Use this form to add a new credit, debit, or HSA card.
For guardians to complete at any time to help your child counselor keep track of progress.
For teens and guardians to complete together to help your counselor keep track of progress.
For clients of Cameron Dumas to complete before sessions.
Please call or complete request to have one emailed to you.
If you are having issues with our e-sign forms, or prefer to complete forms by hand, feel free to print forms here.
You can return forms by emailing them to firstname.lastname@example.org or faxing them to 432-897-0966. If you would like to return them in person please call ahead to make sure office staff is present.
We are so excited to meet you! Many of our providers may currently be on a waiting list due to the shortage of mental health providers in our community. We want to make sure we find you a counselor who meets all of your needs, even if its not with us. Please call Lindsey to discuss all your needs and options and we will get you where you need to go!