Path to Change Counselor Children Marriage Family Trauma Sexual Issues Grief Teenagers Youth Young Adults
Path to Change Counselor Children Marriage Family Trauma Sexual Issues Grief Teenagers Youth Young Adults
Path to Change, LLC Christian Counseling Services Heather Cobb Cumming GA Counselor
   Path to Change, LLC                                      Christian Counseling Services Heather Cobb Cumming GA Counselor

New Client Forms

Please print out and complete the appropriate forms and bring with you to your first session.  
If you do not have access to a printer, we will have the forms for you in our office. 

 

Adult Form & Informed Consent Form - Path to Change, LLC Counseling
Initial intake, information, and consent to treatment at Path to Change, LLC
Adult Intake and Informed Consent Form -[...]
Adobe Acrobat document [397.0 KB]
Child/Adolescent Forms & Informed Consent Form - Path to Change, LLC Counseling
Initial intake, information, and consent to treatment at Path to Change, LLC
Child Intake and Informed Consent Form -[...]
Adobe Acrobat document [492.2 KB]

Additional Forms

Release of Information - Path to Change, LLC Counseling
Consent and authorization to release information.
Path to Change Release of Information Fo[...]
Adobe Acrobat document [87.3 KB]
Informed Consent Form - Path to Change, LLC Counseling
Information, rates, authorization and consent to treatment at Path to Change, LLC
Informed Consent Adult - Group Practice [...]
Adobe Acrobat document [226.4 KB]
Credit Card Authorization Form - Path to Change, LLC Counseling
This form/credit card information will be held in this office until all sessions have concluded and form returned to client.
Path to Change Credit Card Authorization[...]
Adobe Acrobat document [48.2 KB]

Important Notices

Notice of Privacy Practices 2018 - Path to Change, LLC Counseling
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Path to Change Notice of Privacy Practic[...]
Adobe Acrobat document [116.6 KB]
Path to Changen Heather Cobb Counseling Cumming Christian Counselor Therapy Anxiety Help Heather Cobb, MA LPC Path to Change Counseling Services
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Copyright Path to Change, LLC/Heather Cobb 2018
314 Tribble Gap Road, Suite B Cumming, GA 30040
770.615.6115 - Office 678.403.0334 - Fax
counseling@pathtochange.net