Referral Form

For offices and providers wishing to refer a patient to Rachel. Please complete the form and email to 

New Patient Packet

For all patients.  Please print and sign these documents to bring with you to your appointment

Adult Intake Form (18+)

Please complete and print this form and bring it with you to your office appointment

Request for Release of Information

Please use this form when requesting that your health information be released to another provider or facility

Rachel Christian Counseling

Child & Adolescent Intake Form

(Under 18 years old)

Please complete and print this form to bring in with your child or adolescent to his or her appointment