Fresh Start Counseling

Intake Paperwork

Click here to learn how we keep your sensitive information secure.

 

• ​Please click here to electronically submit your Demographic information ​to your therapist.

• If the patient is an ADULT (21+), click here to complete an initial screening.

• If the patient is a YOUTH age 10-20, please have the YOUTH click here to complete a screening.

• Please click here to download/print our Fee Agreement.  Please bring a Patient/Parent/Guardian signed copy to your first appointment, and retain a copy for your records.

 

• If MaineCare is paying for any/all of your services, please click here to download/print our Service Agreement.  Please bring a Patient/Parent/Guardian signed copy to your first appointment, and retain a copy for your records.  We are affiliated with Sweetser, and bill all MaineCare services through Sweetser.  Sweetser is a non-profit organization supporting a network of affiliated therapists in private practices throughout Maine.

• For ALL other PAYMENT SOURCES, please click here to download/print our Service Agreement.  Please bring a Patient/Parent/Guardian signed copy to your first appointment, and retain a copy for your records.

Service Agreements