Inner Strength Counseling

Individual, Couple, Adolescent, and Family Counseling

Eleanor Salemi, LCSW

Florida Lic. SW9620

2840 West Bay Dr., Suite 253

Largo, FL 33770


Fax: 866.706.0538


Intake Packet – Individual Adult
(18 and Over)

Personal History for Individual Adults


Payment Contract for Services (Fee Agreement)

Privacy of Information Policies


Recipient's Rights Notification (read and keep)


Consent to Treat


Services Provided


Credit Card Authorization

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