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Life Cycle Family Counseling
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Patient Forms

Please read our Notice of Privacy Practices before completing any of the forms below.

Electronic Forms

Before your first session please fill out and submit electronic forms 1-6.

  1. Consent to Treatment
  2. Billing and Insurance Info
  3. Teletherapy Consent
  4. Client Information
  5. Client Email/Texting Informed Consent
  6. Adult Psychosocial History
    (over 18 years old)
    OR
    Child/Adolescent Psychosocial History
    (under 18 years old)
  1. Covid-19 Liability Waiver
  2. Release of Information

Printable Forms

  • Consent to Treat
  • Billing and Insurance Info
  • Teletherapy Consent
  • Release of Information

Workshops

  • 2021 Parent Camp Handout
Life Cyle Family Counseling, Inc. • 39293 Plymouth Road, #110 • Livonia, MI 48150 • (734) 462-4999