The Intake Packet forms, previously only mailed to new clients, are now available on this website for you to download to print out and complete by hand, and then send them to the AFCCenter practice by email, fax, or via the US Postal Service.
Click on each form below to open and download it:
- A Welcome letter from our Director, Herbert Jay Rosenfield, LCSW
- The frequent “Goals of Therapy”
- Directions to the Cheshire office
- Clients’ Rights and Responsibilities
- HIPAA Policies and Agreement Form
- Client Information Form
- Acceptance of Telehealth Services
- Our Relationship and Our Financial Practices
To send forms to the Cheshire office of The
ADOLESCENT & FAMILY COUNSELING CENTER:
The Republic Building
350 South Main Street Cheshire, CT 06410
Phone: (203) 271-1234
Fax: (203) 272-9094
To send forms to the Danbury office of The
ADOLESCENT & FAMILY COUNSELING CENTER:
72 North Street – Suite 205,
Danbury, CT 06810
Phone: (203) 790-1234
Fax: (203) 743-1110