Inner Strength Counseling

Individual, Couple, Adolescent, and Family Counseling

Eleanor Salemi, LCSW

Florida Lic. SW9620

2840 West Bay Dr., Suite 253

Largo, FL 33770

727.418.0735

Fax: 866.706.0538

Email

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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