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ADULT INTAKE ASSESSMENT1 This information is part of your confidential medical record. Your answers are important to providing the best possible treatment. Please answer as many questions as possible.
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Western Arkansas Counseling & Guidance Center is a non-profit organization that provides mental health services and counseling in Western Arkansas.
Individuals or organizations who have received services from Western Arkansas Counseling & Guidance Center may be required to file certain forms for reporting purposes.
To fill out the Western Arkansas Counseling & Guidance Center forms, individuals or organizations must provide accurate and complete information regarding the services received and any payments made.
The purpose of the Western Arkansas Counseling & Guidance Center forms is to accurately report the services provided and payments received for mental health services.
Information such as the type of services received, the dates of service, and any payments made for the services must be reported on the Western Arkansas Counseling & Guidance Center forms.
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