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Counseling Forms


Life Compass 101, PLLC


919.809.9101
Offices located in Cary and Raleigh, NC


If you are a new client you will be required to complete two forms at least 24 hours prior to your first appointment. Please follow the steps below.

After you click on the link at the bottom of this page, you will need to complete two easy steps outlined below. If at any time you wish to return to the instructions on this page, use the back button
. Once you have registered, you will be sent an agreement outlining the terms of our work together. Please bring this agreement to your first appointment.

1. Click the link below. This will take you to the Register as a new patient/client
button located at the bottom of the page. If you plan to use insurance, have your insurance card/details available. You will also be asked to choose a user name and password. You will need the user name and password to complete step #2.

2. Once you have completed and submitted the registration form, you will be asked to completed a biographical information form.
Be sure to complete all sections. The information is stored on a secure encrypted system.

 
If you have any questions or want to ask about available appointment times, send me a message from the link below. Have your user name and password ready. You can retreive your password if you have forgotten it.

I want to send a message or ask a question

* Please note that you will not be able to make an appointment online. If are able to view a calendar, please realize that this does not reflect available appointment times. Thank you!


Click Here to Complete Counseling Intake Forms