For your safety and convenience

We are providing the following HIPAA Compliant online forms. Please access and complete the necessary intake forms by clicking on the link for each section.  
Information Packet

Click to download PDF

Demographics
CLICK HERE
Substance Use History
CLICK HERE
Infectious Disease Risk Assessment
CLICK HERE
HIPAA Consent Form
CLICK HERE
Consent for Treatment
CLICK HERE

©2016 Phoenix Counseling Center, Inc.  All rights reserved .   

 149 South Main Street    PO Box 1257    Phoenix    Oregon    97535

541-535-4133    fax 541-535-5458

info@phoenixcounseling.org