Welcome to Visiting Counselors

To complete our intake forms, please scroll down and review each document carefully. You will be able to electronically sign the forms directly on this page.

Please note:

• You must click the “Continue” button at the bottom of the PDF to begin completing the forms.

• You must enter an email address on the first page of the intake packet.

• After completing the forms, you must click the confirmation link that will be emailed to you. This step is required to finish the submission process.

Para completar nuestros formularios de admisión en español, por favor haga clic aquí.

If you prefer to complete paper forms, you may download the forms using the link provided below the PDF. Completed forms can be mailed or faxed to:

ATTN: Visiting Counselors
PO Box 330
Commack, NY 11725

Fax: (516) 418-5377

If you have any questions or need assistance, please contact our office at (516) 698-5511. We are happy to help.