“Yesterday is gone. Tomorrow has not yet come. We have only today. Let us begin.” 

Mother Teresa

Individual Intake Form

Click on the orange box below to access the form. You can then download it to your computer to complete the information.

Type your responses and tab between items that are underlined to go to the next response field.

For boxes, click to check those items. To uncheck a box, click on the check mark.

Email the form to Dr. John Thomas at Phoenix Counseling or print the completed form and bring it to your first appointment.