(916) 905-5875

Kid Power Counseling

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Kid Power Counseling

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    • Home
    • Therapy Services
      • Therapy Services
      • Play Therapy
      • Family Therapy
      • Parent Coaching
      • Co-Parenting Program
    • About Us
    • Contact Us
    • Intake Forms
  • Home
  • Therapy Services
    • Therapy Services
    • Play Therapy
    • Family Therapy
    • Parent Coaching
    • Co-Parenting Program
  • About Us
  • Contact Us
  • Intake Forms

Intake Forms

Please Download Intake Forms and Complete Prior To Appointme

Minor Intake Form, Informed Consent, Symptom Checklist. and Credit Card Authorization Forms


Kid Power Counseling Minor Intake Form (pdf)Download
Informed Consent (pdf)Download
About Your Child's Symptoms (pdf)Download
Pediatric Symptom Checklist (pdf)Download
KPC Credit Card Form (pdf)Download
Protected Heath Care Release Form (PHI Release Form) (pdf)Download
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Kid Power Counseling

11879 Kemper Road Ste 12B, Auburn, Ca 95603

(916) 905-5875

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Copyright © 2019 Kid Power Counseling