Intake Assessment - New Clients
Welcome to Cooper Counseling. This confidential assessment helps me understand your unique needs and develop your personalized treatment plan. Please answer as honestly as possible - there are no right or wrong answers. All information is protected by HIPAA, professional ethics, and applicable laws.

This assessment takes approximately 40-60 minutes to complete. You can save your progress and return to finish later if needed.
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This form was created inside of Gabi Cooper.