New Client Intake Packet

To ease the process for new clients, we've provided a New Client Intake Packet on this page. It includes a Client Information page, Client History form, the Fee and Cancellation Agreement and the Illinois HIPAA Privacy Notice. If possible, please take a few minutes to download and fill out the forms prior to your first appointment.

To download and print the PDF, click the link on the left. Once the PDF has opened in Adobe Reader, you can print the forms and fill them out at your convenience.

If you have any questions, feel free to contact us:

• Schaumburg Office: (847) 240-5080

• E-mail: info@coretherapyassoc.com