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Client Forms

Telehealth Consent Form (To be completed if you are engaging in virtual counseling services):
If you're a first-time client or parent/guardian of a client, please print, review, and complete the designated forms below.  Please bring the completed forms with you to your first appointment or you can email them back to admin@thebinduinstitute.com.  If you have any questions on which forms to fill out, please call our office at 850-692-9824.
Adult Intake Packet:
Couples Intake Packet (To be completed by both parties):
Minor Intake Packet for Ages 5-10 (To be completed by the parent/guardian):
Adolescent Intake Packet for Ages 11-17 (One form to be completed by parent/guardian and the other form to be completed by adolescent):

To be completed by the parent/guardian:



To be completed by the adolescent