Change of Therapist Request Form
Instructions: If you are interested in changing therapists at Seoul Counseling Center, we do allow that. We typically encourage you try to discuss with your therapist first directly about any concerns you have about therapist fit, and often clear communication can resolve many concerns clients have regarding therapist fit. That said, you have the right to make a request to change therapists at any time at our Center.

To do so, you can complete and submit the form below. Our Center Manager or Clinical Director will then contact you to discuss next steps within 1-3 business days. If you prefer to submit a hard copy form instead (or to speak about this directly with our Clinic Director or Center Manager), please let our Front Desk know.
Client's Name *
Your answer
Therapist Name *
Your answer
Client’s reason(s) for request to change therapist: *
Required
Have you spoken to your original therapist about this Request to Change Therapist? *
Your desired therapy format is: *
Required
Your preference for new therapist: *
Required
I, the client, grant permission for my current therapist to transfer clinical notes to new therapist. *
Desired date for change (if not ASAP)
MM
/
DD
/
YYYY
Any Additional Comments
Your answer
Submit
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