The Center for Counseling Arts

If you have not scheduled your first appointment, our office will call you shortly afterwards to confirm individual availability.

The form below includes questions concerning your contact information, your health insurance provider (if applicable) and a brief personal history.

 You will have the opportunity to submit your Health Insurance ID Card online through your smartphone, tablet or computer.

If you prefer, you may upload your card later through the ID Upload Portal accessible from the New Client Page found on the top navigation bar of our homepage. Or, you can bring your card to your first appointment.

If you would like to request a recommendation before submitting your intake, our director, Dr. Nancy Lardo, PhD, is glad to help.

• Request Recommendation 

If you prefer to print our form to deliver by hand or post, you may download it here.  

 For your security and privacy, the information you submit will be sent in a secure encrypted transmission that protects your sensitive information.

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