Inner Strength Counseling

Individual, Couple, Adolescent, and Family Counseling

Eleanor Salemi, LCSW

Florida Lic. SW9620

801 West Bay Dr., Suite 422

Largo, FL 33770

727.418.0735

Fax: 866.706.0538

Email

Hours

Directions

Intake Packet – Couples

Personal History for Individual Adults (each person is required to complete and sign their own form)

No Secrets Policy For Couples and Families (signed by both)

Payment Contract for Services (Fee Agreement) (signed by person responsible for payment)

Privacy of Information Policies (only requires one signature)

 

Recipient's Rights Notification (read and keep)

 

Consent to Treat (each person signs one)

 

Services Provided


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