Forms for Counseling Clients
Welcome New Clients!
To begin utilizing our Counseling services, please call 541-757-8068 and speak with our Intake Coordinator. After completing our phone intake, complete and return the appropriate forms below prior to your initial appointment/mental health assessment.
Return forms to Alex Moore, Intake Coordinator & Clinical Support Specialist via:
- Fax: 541-758-1030
- USPS mail or Old Mill Center mailbox drop-off: 1650 SW 45th Place, Corvallis, OR 97333
New Client – Minor (under age 14 years)
| Parent/guardian, read and review: | |
|---|---|
| • Counseling Services Information Packet | |
| • Privacy Practices Booklet |
New Client – Teen or Adult (age 14+)
| Please read and review: | |
|---|---|
| • Counseling Services Information Packet | |
| • Privacy Practices Booklet | |
| • Client Rights |
Current Clients – Grievance Process
Old Mill Center continually strives to provide the highest quality of care. If, however, you have a concern regarding your counseling experience, we encourage you to submit the following form at any time. We will respond in writing within 20 calendar days.
