Welcome to Visiting Counselors!

TO COMPLETE OUR INTAKE FORMS PLEASE SCROLL DOWN ON THE PAGE TO REVIEW AND ELECTRONICALLY SIGN THE DOCUMENTS. PLEASE NOTE THAT YOU MUST CLICK THE "CONTINUE" BUTTON AT THE BOTTOM OF THE PDF TO BEGIN COMPLETING THE FORMS.

PLEASE ALSO NOTE THAT YOU MUST ENTER AN EMAIL ADDRESS ON THE FIRST PAGE OF THE INTAKE & UPON COMPLETION YOU MUST CLICK THE CONFIRMATION LINK THAT WILL BE EMAILED TO YOU.

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

If you prefer, you may download the forms by clicking the link provided below the PDF, then mail the completed documents to:

ATTN: Visiting Counselors
PO Box 330, Commack, NY 11725,
or fax them to (516) 418-5377.

If you have any questions or need assistance, please don't hesitate to contact our office at (516) 698-5511. We’re here to help!