Form​s

In order for us to provide the best possible counseling services to you, certain information is important for us to know. This is why your privacy is a priority to us at Hubbard and Welch Counseling. The following forms provide us with some of that information, while protecting your privacy and letting you know of your rights. Please review these forms prior to your first session.

If you have access to a printer, please bring a completed copy of the indicated "Intake Packet" to your first session. If not, we will provide you with a copy to sign upon your arrival. If you do not fill these forms out ahead of time, please arrive 10-15 minutes early to your first session.

If you have any questions about your privacy, our policies, or your rights, please contact us.

Jaman Welch, Ph.D. Forms

Please click on the appropriate form packet, print, fill out and bring with you to your first appointment.

*Please complete this form if you or your child is 16 years of age or older. If you or your child is under 18 years old, a parent or guardian must sign the Billing and Disclosure Document.

*Please review this information, and sign where indicated on the Billing and Disclosure Agreement in the Intake Packet stating that you agree to these terms.

What our customers are saying

 "If you don't like something, change it. If you can't change it, change your attitude"  -Maya Angelou

Jane Doe - Another Company, LLC

Uma (Tina) Hubbard, LCSW-R Forms

Please click on the appropriate form packet, print, fill out and bring with you to your first appointment.

*Please complete this form if you or your child is 16 years of age or older. If you or your child is under 18 years old, a parent or guardian must sign the Billing and Disclosure Document.

*Please complete this form for your child if he/she is between ages 12-16. A parent or guardian must sign the Billing and Disclosure Document.

*Please complete this form for your child if he/she is under 12 years of age.  A parent or guardian must sign the Billing and Disclosure Document.

*Please review this information, and sign where indicated on the Billing and Disclosure Agreement in the Intake Packet stating that you agree to these terms.