Intake Forms

We ask that everyone involved in therapy to please fill out a form.

You may complete Intake Forms online by requesting access to our Online Intake form over the phone.

If you are a couple coming in, we need a form for both parties.

If you are bringing in a child, we will need an intake form filled out by the parent(s)/guardian(s).

Samaritan Counseling Center of the Capital Region © 2015 • Site MapEmployee Portal• (518) 374-3514• Fax (518) 374-9193