You may choose to either download the first link (CCC Individual Fillable Pack) and fill it out on your computer or download and print the contents of this page after scheduling your initial individual counseling appointment with your therapist. Please be sure to complete all forms, including signing the HIPAA form on the back page. You may then scan all your files into (preferably) ONE continuous pdf file and submit it with the secure file transfer mechanism at the bottom of this page. Alternatively you can snail-mail the documents to our office:

Cary Counseling Center

875 Walnut Street Suite 275

Cary, NC 27511

Individual Forms – Fillable Pack

 

Patient Registration

Service Agreement

APS HIPAA Form

Safety&Symptoms

Release of Information

Please use the following file transfer mechanism if you choose to send files over the internet to your therapist. DO NOT USE REGULAR NON-SECURE EMAIL. Attach your file(s) at the very bottom and make sure you add your therapist’s name in the comments section to assist our routing.