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Linganore Counseling and Wellness LLC

Counseling and Mental Health

Patient Forms

In order to get the most out of your first session, make sure to complete and bring with you the first three  attached client forms:

1. Statement of Understanding: This form explains client/therapist confidentiality and limits of confidentiality. Signing also indicates you have read about our Fees and Insurance.

2. Patient History: Brief form to help understand the client's personal, employment, legal, medical and counseling background and history.

     Child Patient History:Brief history form for children and adolescents

3. Patient Information Form: We need this information for contacting you, reminding you of your appointments as well as billing your insurance.


  Additional Forms:

Agreement for Parents:Required agreement for divorced families seeking counseling for minor children.

Authorization for Release: Form giving consent for therapist to speak to people other than the client.

If you have any questions regarding the forms please contact us at 301-865-2226 x302