If you're a new client, please complete the following intake forms and bring them with you to your first therapy session.

If you would like for Neuro Harmony to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of pertinent information:

Client Release of Information Form

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

Marriage and Family Therapy, CBT, DBT, EMDR, Trauma Therapy & Play Therapy

Charleston, IL Counselors

Neuro Harmony, LLC

Client Intake Forms