Motivations Counseling – Client Forms

New Clients:

Please print and complete one of the following "New Client Forms" packets and bring it with you to your first therapy session:

Individual Adult (18+) Packet

Child/Teen Packet

Couples Packet

Client Packet - Ruba Afifi, Therapist

Existing Clients:

If you need us to release your therapy/treatment information to a third party, please complete the following form authorizing us to do so:

Authorization to Release Information


Please print and fill out the required forms.  Bring them with you to your next scheduled appointment or scan and email them to the following address:

Note: To download Adobe Acrobat Reader for free, click here.