Downloadable Forms

Forms for Ismael E. Gerena Jr.

New Clients

Please print and complete these forms before your initial appointment, or to update information that has changed.

Adult Checklist of Concerns

Please complete one checklist for each person attending counseling.

  • If you feel the item checked is an issue of your relationship please place an ‘R’ before the box.
  • If you feel the item checked is an issue of your family system please place an ‘F’ before the box.
New Client Information Form

Please complete the new client information form for each person participating in counseling.  This form is fallible in Adobe Acrobat and can also be printed and filled out by hand.

 

To view these files you can use Preview on a Mac OS computer or Get Acrobat Reader for all major operating systems.