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Forms

Below are forms that you may need to sign for our records.

  If you are a new patient, please complete this form.

Intake Form 

  If the patient is a child, please complete this form.

Child Intake Forms
  If you are requesting an Immigration Evaluation,
  please complete these forms.

Immigration Evaluation Forms

APA Forms

  If you need to give your therapist consent to release or acquire    information from another party, please complete this form.

Consent for Release Information

  If you are requesting services to include attending court, or       other court services, please complete this form.

Retainer


 

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Rio Grande Counseling Center
314 E Highland Mall BLVD. STE 252; Austin TX 78752-3733
512-560-7196 Email: dgarzalouis@gmail.com