Licensed Professional Counselor, Certified Addictions Counselor
and trained Family Therapist
0ffering individual, couples, family and group therapy Specializing in integrating traditional therapy & alternative holistic modalities
HOLISTIC ASSESSMENT FORM
Download the Holistic Mental Health Assessment Form (PDF)*
Introduction:
Filling out the following form is the first step in the Holistic Mental Health Assessment that forms the foundation for your mental health care in my practice. Please take some reflective time to fill this out. This is the first step in making a very important investment in beginning to address the particular issues you are seeking help for. If you feel you need help filling out the form you are welcome to come to my office and fill it out receiving support and suggestions as you go along, or feel free to call me with questions.
Please mail this to:
Rhoda Fuchs-Morton
10 Church Rd.
Elkins Park, PA 19027
It is important that I receive the form at least two days prior to your first scheduled visit so that I have time to thoroughly review it. You may write on the back of each page if there is not enough space under each question.
*Adobe Acrobat Reader is required to view this form (download Acrobat here).