Counseling Intake Forms

1) Please fill out the forms below and either bring them to your first appointment or make arrangements to mail, scan & email, or deliver before 1st appointment:

Self Awareness Counseling
7409 SW Capitol Hwy
Suite 207
Portland, Oregon 97219

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Self-Awareness Counseling  •  7409 SW Capitol Hwy, Suite 207  •  Portland, Oregon 97219  •  (503) 729-9662

Serving The Greater Portland Area, Tigard, Beaverton & Lake Oswego, including the following Neighborhoods:
Arnold Creek, Ashcreek, Bridlemile, Corbett / Lair Hill, Collins View, Crestview, Far Southwest, Forest Highland, Goose Hollow, Hayhurst, Healy Heights, Hillsdale, Homestead, Maplewood, Markham, Marshall Park, Metzger, Multnomah, Raleigh Hills, South Burlingame, Southwest Hills, West Portland Park.

© Deborah Orandon, Self Awareness Counseling, Portland, Oregon ( Multnomah Village )
2) Please read the documents below.
At your first appointment we will go over these and sign together.

Teen or Couples Intake Forms

These forms will be sent to you by arrangement.

Adult Intake Forms

Client Information
Client Profile
Client Concern Checklist

Professional Disclosure Statement
HIPAA (Privacy Rules)
Self Awareness Counseling, Portland Oregon, logo
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