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Forms

For your convenience, we’ve provided access to important forms that may be required before or during your care. Completing these forms ahead of time can help streamline your first visit and ensure we have the information needed to best support you. If you have any questions while filling them out, please don’t hesitate to contact us.

We’re here to help.

Medical History

Tele-health Consent

Client Service Agreement

Adult Demographic 

Release of Information

Privacy Policy

Black Lotus Counseling Center

Black Lotus Counseling Center

2431 Bethany Rd Ste B, Sycamore, Il 60178

(779)367-5472

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