Family Counseling Center
For Scheduling Call: (763) 682-5420
Intake Paperwork- Please print all 3 forms and complete
If the client(s) is/are 18 or over choose the adult form
Marital therapy clients print one for each
person to complete
If the client is 11-17 choose the adolescent form
There is part for the parent and for the
adolescent to complete
If the client is under 10 please choose the child form.
HIPPA Notice is for your records only
IN ADDITION please print the appropriate questionnaire that applies to you.
